Pathological Insights into Non-Neoplastic Renal Parenchyma in Wilms Tumor: Implications for Nephron-Sparing Surgery.

IF 1.5 3区医学 Q2 PEDIATRICS European Journal of Pediatric Surgery Pub Date : 2024-10-18 DOI:10.1055/s-0044-1791846

Mingchuan Huang, Man Shu, Zhe Xu, Lin Wang, Longshan Liu, Juncheng Liu, Huanxi Zhang, Shicong Yang, Changxi Wang, Pengfei Gao

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Abstract

Introduction: This study aimed to evaluate the non-neoplastic renal parenchyma in Wilms tumor (WT) and investigate its impact on nephron-sparing surgery (NSS).

Materials and methods: The non-neoplastic renal parenchyma of WT patients was prospectively collected for pathological examination. The histology of non-neoplastic renal parenchyma was assessed from two perspectives: nephrogenic rests (NRs) and nephrons.

Results: A total of 46 non-neoplastic renal parenchyma specimens were collected from 42 WT patients. The surgeons assessed the median proportion of non-neoplastic renal parenchyma as 30%, whereas using ellipsoid volume, it was calculated to be 27%. The Youden index of surgeons' assessment peaked at a 15% proportion of non-neoplastic renal parenchyma. The bilateral WT (BWT) group and NSS group exhibited significant differences compared with the unilateral WT group and radical nephrectomy group, respectively, with the BWT group showing a tendency toward thickened basement membrane.

Conclusion: The presence of NRs and endogenous nephron alternations should be given due attention in WT. The probability of abnormalities is low when the proportion of non-neoplastic renal parenchyma exceeds 15%, providing pathological support for expanding the adaptation of NSS.

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对 Wilms 肿瘤非肿瘤性肾实质的病理学认识：保肾手术的意义。

简介：本研究旨在评估 Wilms 肿瘤（WT）非肿瘤性肾实质，并探讨其对保肾手术（NSS）的影响：本研究旨在评估 Wilms 肿瘤（WT）非肿瘤性肾实质，并探讨其对保肾手术（NSS）的影响：前瞻性收集WT患者的非肿瘤性肾实质进行病理检查。从肾原性休止期（NRs）和肾小球两个角度对非肿瘤性肾实质的组织学进行评估：结果：共从 42 名 WT 患者身上采集了 46 份非肿瘤性肾实质标本。根据外科医生的评估，非肿瘤性肾实质的中位比例为 30%，而根据椭圆体体积计算，非肿瘤性肾实质的中位比例为 27%。外科医生评估的尤登指数达到峰值，非肿瘤性肾实质的比例为 15%。双侧WT（BWT）组和NSS组分别与单侧WT组和根治性肾切除组相比有显著差异，其中BWT组显示出基底膜增厚的趋势：结论：在 WT 中，NRs 的存在和内源性肾小球交替应得到充分重视。当非肿瘤性肾实质的比例超过 15%时，出现异常的概率较低，这为扩大 NSS 的适应范围提供了病理学支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pediatric Surgery 医学-外科

CiteScore

3.90

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： This broad-based international journal updates you on vital developments in pediatric surgery through original articles, abstracts of the literature, and meeting announcements. You will find state-of-the-art information on: abdominal and thoracic surgery neurosurgery urology gynecology oncology orthopaedics traumatology anesthesiology child pathology embryology morphology Written by surgeons, physicians, anesthesiologists, radiologists, and others involved in the surgical care of neonates, infants, and children, the EJPS is an indispensable resource for all specialists.