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Title: Displasia intra-epitelial tubular renal em carcinoma de células renais: caracterização de sua importância como precursora biológica do carcinoma de células renais
Keywords: Carcinoma renal;  Displasia intraepitelial tubular renal;  Tissue microarray;  Antígeno Ki-67;  Proteína p53;  Renal cell carcinoma;  Intratubular epithelial dysplasia;  Tissue microarray;  Ki-67;  p53 protein;  Carcinoma de células renais;  Rim-Anormalidades;  Rim-Patologia;  MEDICINA;  ANATOMIA PATOLÓGICA
Issue Date: 30-Dec-2008
Abstract: Renal cell carcinoma is one of the most malignant urological diseases, corresponding to 1-3% of solid tumors in adults. The finding of intratubular epithelial dysplasia (IED) next to tumor areas suggests that this can be the biological precursor of some types of renal cell carcinoma (RCC). The main objective of this study is to identify IED in areas of non neoplastic kidney with RCC. Other objectives are: (1) evaluate the incidence of IED in RCC subtypes, (2) evaluate the use of tissue microarray (TMA) to study IED and RCC and (3) compare immunohistochemistry (IHC) results with Ki-67 and p53 protein to confirm the evidence that IED is the biological precursor of RCC. This study was performed in 182 archival material from nephrectomy surgical specimens from Instituto Nacional de Câncer, between 2000 and 2005. IED was diagnosed in 75 cases, that were studied by TMA with Ki-67 and p53 protein IHC. TMA validation assay demonstrated that the use of two tissue cores with 1 mm2 each was suitable to evaluate RCC and IED. Statistical analysis demonstrated no difference in p53 e Ki-67 IHC between dysplastic and tumoral areas, but there was difference when compared to normal controls. Regression test demonstrated weak to moderate tendency to predict tumoral positivity through dysplastic area results with Ki-67 and p53 protein, respectively.
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