【摘要】 目的通过对56例经根治性肾切除术取得的肿瘤假包膜行染色观察和统计分析,提高对肾癌假包膜附近肿瘤微环境和局部浸润方式进一步了解,为肾部分切除术的安全性和无瘤原则进行指导。方法收集2009年6月至2010年7月在本单位行根治性肾切除术的组织学标本56例,行苏木素染色并进行统计学分析。观察肾癌假包膜局部肿瘤微环境;对假包膜外侧肿瘤浸润情况进行统计分析。结果56例肾癌中,45例具有完整假包膜,假包膜局部微环境是由成纤维细胞束、癌细胞和炎细胞构成。其中癌旁组织出现肿瘤浸润11例,浸润范围<0.2cm者9例,浸润0.2⁰.5 cm者1例,仅1例>0.5cm,但均局限在1.0cm之内。结论肾癌假包膜是癌细胞增殖浸润的主战场,T_1a期肾癌可以突破假包膜实现肿瘤进展,因此在进行肾部分切除术时应注重无瘤原则。更多还原

【Abstract】 Objective To improve our understanding of the tumor micro-environment of the renal cell carcinoma and the local invasion near the pseudocapsule（PC）,and to guide the safety and tumor-free principles for partial nephrectomy by observation and statistical analysis of 56 cases of renal cell carcinoma,obtained by radical nephrectomy. Methods Fifty-six histological specimens of renal cell carcinoma were collected from June 2009 to July 2010 in the department of Urology,and H staining and statistical analysis were performed. The local tumor micro-environment of pseudocapsule were observed,and the pseudocapsule infiltrationed by the tumor tissue was analyzed. Results The 56 cases of renal cell carcinoma,45 were surrounded by a continuous pseudocapsule completely,and the PC local microenvironment was composed of fibroblast bundles,cancer cells and inflammatory cells. Among them,there were 11 cases of tumor invasion,infiltration range less than 0. 2 cm in 9 cases,infiltration ranged from 0. 2 to 0. 5 cm in 1 case. Only in 1 case the infiltration range was over0. 5 cm,but all infiltration ranges were limited within 1. 0 cm. Conclusions Renal cancer pseudocapsule is the main battlefield for cancer cell proliferation and invasion,T_1a stage renal cancer can break through the pseudocapsule to achieve tumor progression. We should pay attention to the principle of no tumor when performing partial nephrectomy（ PN）.更多还原