Updates in Grading of Renal Cell Carcinomas Beyond Clear Cell Renal Cell Carcinoma and Papillary Renal Cell Carcinoma

被引:8
|
作者
Paner, Gladell P. [1 ,2 ]
Chumbalkar, Vaibhav [1 ]
Montironi, Rodolfo [3 ]
Moch, Holger [4 ]
Amin, Mahul B. [5 ,6 ]
机构
[1] Univ Chicago, Dept Pathol, 5841 South Maryland Ave,Room AMB S641-MC 6101, Chicago, IL 60637 USA
[2] Univ Chicago, Dept Surg, Sect Urol, 5841 S Maryland Ave, Chicago, IL 60637 USA
[3] Polytech Univ Marche Reg, Dept Clin & Mol Sci, Mol Med & Cell Therapy Fdn, Ancona, Italy
[4] Univ Hosp Zurich, Dept Pathol & Mol Pathol, Zurich, Switzerland
[5] Univ Tennessee, Hlth Sci Ctr, Dept Pathol & Lab Med, Memphis, TN USA
[6] USC Keck Sch Med, Dept Urol, Los Angeles, CA USA
关键词
renal; carcinoma; grade; prognostic; chromophobe; SDH; mucinous; TFE3; TFEB; WHO; ISUP; COLLECTING DUCT CARCINOMA; TUBULOCYSTIC CARCINOMA; MEDULLARY CARCINOMA; HEREDITARY LEIOMYOMATOSIS; PROGNOSTIC-SIGNIFICANCE; INTERNATIONAL SOCIETY; MORPHOLOGIC SPECTRUM; DISTINCT ENTITY; TUMOR; KIDNEY;
D O I
10.1097/PAP.0000000000000341
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
The World Health Organization (WHO) recommends grading of clear cell renal cell carcinoma (RCC) and papillary RCC using the WHO/International Society of Urological Pathology (ISUP) grade, which is primarily based on nuclear features. As the spectrum of RCC continues to evolve, with more recently described subtypes in the past decade, literature evidence on grading these subtypes is limited or not available for some tumor types. Herein, we outline a pragmatic approach to the topic of grading RCC, dividing the contemporarily described RCC subtypes into 7 categories based on the potential clinical applicability of grading as a useful prognostic parameter: (1) RCC subtypes that are reasonably validated and recommended for WHO/ISUP grading; (2) RCC subtypes where WHO/ISUP is not applicable; (3) RCC subtypes where WHO/ISUP grading is potentially clinically useful; (4) inherently aggressive RCC subtypes where histologic classification itself confers an aggressive biologic potential; (5) renal epithelial tumors where WHO/ISUP grading provides potentially misleading prognostic implication; (6) renal epithelial neoplasms where low WHO/ISUP grade features are a prerequisite for accurate histologic classification; and (7) renal epithelial neoplasms with no or limited data on grading or incomplete understanding of the biologic potential. Our aim in outlining this approach is 2-fold: (a) identify the gaps in understanding and application of grading in RCC subtypes so that researchers in the field may perform additional studies on the basis of which the important pathologic function of assignment of grade may be recommended to be performed as a meaningful exercise across a wider spectrum of RCC; and (b) to provide guidance in the interim to surgical pathologists in terms of providing clinically useful grading information in RCC based on currently available clinicopathologic information.
引用
收藏
页码:117 / 130
页数:14
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