Nephroblastoma is a success of paediatric oncologic therapy. How further can we go?: Results of a cyto-histologic correlation study.
Nephroblastoma is a success of paediatric oncologic therapy, yet, there are still some cases where favourable response to preoperative chemotherapy is not achieved. Fine needle biopsy has the role of diagnostic confirmation and, idyllically of predicting a response to preoperative chemotherapy. To advance in this aim, we retrieved a total of 14 nephroblastomas, (seven male patients and seven female with a mean age of 44.4 months), diagnosed in our department by fine needle biopsy and submitted afterward to chemotherapy and nephrectomy, in the last 10 years. Correlation between cytologic features, (morphology, cell death, and proliferation (Ki-67 labelling index), and post chemotherapy tumour evaluation was done. Cytologic pattern per se was not predictive of histologic tumour classification (P = 0.6061). We did not find any correlation between the percentage of necrosis and apoptosis (P = 0.682) in cytologic smears and histologic regressive changes but when both these two criteria coexisted in cytologic blastemal component of nephroblastomas, this fact seemed to lead to a favourable response of the tumour to chemotherapy. When evaluation of Ki-67 labelling index was done in the blastematous component present in the smears, divergent results were obtained. The small number of cases prevented any firm conclusions. By summing up, our results support the idea that there are probably two types of blastema in nephroblastoma with different "suicide" potential and chemotherapeutic response. Further studies should be performed to stratify the influence of necrosis, apoptosis, and proliferation in chemosensivity of nephroblastomas.
Hospital de S. João, Serviço de Anatomia Patológica, Al Hernani Monteiro, Porto, Portugal. hbarroca@gmail.com
Helena
H
Barroca
D017209:Apoptosis; D044963:Biopsy, Fine-Needle; D002648:Child; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D008297:Male; D009336:Necrosis; D009396:Wilms Tumor / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery / Q000628:therapy*