2 Çukurova Üniversitesi Tıp Fakültesi, Patoloji Anabilim Dalı, Adana, Türkiye
3 Çukurova Üniversitesi Tıp Fakültesi, Üroloji Anabilim Dalı, Adana, Türkiye
DOI : 10.5146/jcpath.2022.76 Aim: Renal cell carcinomas (RCC) consist 2-3% of all cancers and more than 85% of the renal masses. Eosinophilic and granuler cytoplasmic tumors of kidney are oncocytomas and eosinophilic variants of the cromophobe, papillary and clear cell subtypes of renal cell carcinomas. Currently, there are studies to differentiate these tumors by markers. In our study, we performed claudin 1, 3, 4, 7 and 8 on renal cell carcinoma types and oncocytoma. The results were compared with grade, stage, prognosis and diagnostic impact.
Materials and Methods: Paraffin blocks of 134 renal cell carcinoma cases which were diagnosed at the Pathology Department of Çukurova University Medical Faculty were studied. The material was consisted of 72 clear cell RCC, 26 chromophobe RCC, 24 papillary RCC and 12 oncocytoma cases. Specimens were stained by hematoxylin eosine. Immunohistochemically, Claudin 1, 3, 4, 7 and 8 were evaluated according to their staining intensity, diffusiveness and location.
Results: By claudin 1; 73.1% of chromophobe RCC cases were stained membranous and 91.7% of the oncocytomas were stained cytoplasmically positive. By claudin 3; 81.9% of the clear cell RCC were negative, 100% of oncocytomas were stained cytoplasmically positive. By claudin 4; 95.8% of clear cell RCC, 75% of papillary RCC, 34.6% of chromophobe RCC were negative, 100% of the oncocytoma cases were cytoplasmically positive. By claudin 7; 84.6% of chromophobe RCC were stained membranous positive, 91.7% of oncocytoma cases were cytoplasmically positive. By claudin 8; 73.6% of clear cell RCC and 44.4% of papillary RCC were negative, 100% of oncocytomas were cytoplasmically positive. The specifity of cytoplasmic positivity for oncocytoma and membranous positivity for chromophobe RCC was 91% and the sensitivity was 92% with claudin 7. Where as the specifity of membranous staining for chromophobe and cytoplasmic positivity for oncocytoma was 91% and the sensitivity was 84 %.
Conclusion: As a result, we found out that claudin 1, 7, 8 can be use at the differential diagnosis of oncocytoma and chromophobe RCC, on the other hand claudin 3, 4 can be useful to differentiate oncocytoma from eosinophilic variant of clear cell RCC. Additionally, we also showed the prognostic impact of claudin 1, 3 and 8 especially at the papillary RCC. Our results pointed out that claudins can be used in a panel as a prognostic parameter and diagnostic marker at the differential diagnosis of the RCC types. Further studies with larger series are needed to evaluate their supports at the treatment strategies.
Anahtar Kelimeler : Claudin, Chromophobe, Oncocytoma, Papillary, Renal cell carcinoma