engleski

Morphometrical analysis of renal arteries in patients with renal cell carcinoma

The presence of tumor necrosis in renal cell carcinoma (RCC) is very common and was correlated with different features including tumor size, cell type, nuclear grade as well as microvessel density and the expression of different markers. However, there are no data about the relationship between renal artery changes including atherosclerosis and fibromuscular dysplasia (FMD) and the extent of necrosis in RCC. Purpose of the study: to analyze renal arteries in patients with RCC especially regarding the thickness of medial layer and circumference of the artery using image analyzer. We analyzed a consecutive series of 57 (35 male and 22 female) patients ranging in age from 35-79 years (mean 58.9 years) who underwent nephrectomy due to RCC in the year 2003. The patients had RCC measuring from 2-16 cm (mean 7.1 cm). Renal arteries were cut during nephrectomy up to 2 cm from renal hilus. Specimens were routinely fixed, embedded in paraffin, cut and stained with hematoxylin and eosin, Mallory trichrome method and orcein. The thickness of the media of 40 patients measured from 167.86-1177.21 um (mean 571.35). Renal arteries of 17 patients (11 male, 6 female) were not measured due to technical problems. The mean thickness of media in patients with FMD was 567.33 um, those with arteriosclerosis 637.18 um and with no renal artery changes 551.11. um). There was a difference between the thicknesses of media in different types of FMD (FMD type I = 590.83 um, FMD type IIA was 476.92 um). Renal arteries of patients with arteriosclerosis were larger in comparison to arteries with no changes (4.2 mm: 3.5 mm), and control arteries obtained at autopsy, however this difference was not statistically significant. Renal arteries of patients with RCC and atherosclerotic changes have thicker media and larger diameter in comparison with controls, and those with FMD. The cause of such changes and their relationship to the degree of tumor necrosis and other changes in renal arteries should be further analyzed.

renal cell carcinoma; renal artery; artery thickness; atherosclerosis

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