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Objective To evaluate the prognostic significance of vimentin intermediary filament expression by tumour cells in patients with renal cell carcinoma (RCC) localized to the kidney. Patients and methods Thirty-nine patients with localized RCC (pT1,pT2) were assessed in a retrospective study. Tumour cells were evaluated immunohistochemically for vimentin, epithelial membrane antigen (EMA) and polyclonal cytokeratin expression. The prognosis of cases expressing positive vimentin expression in tumour cells was compared with that of cases with no expression. Additional clinical information and conventional histological grade of the tumours were also included in the survival analysis. Results Univariate analysis of patient survival and tumour recurrence showed a statistically significant association between vimentin-positive tumours and poor patient outcome; the EMA stain showed borderline significance and histological grade was significantly associated with prognosis. The combination of tumour vimentin expression and histological grade provided a better predictor of prognosis and proved to be the best independent prognosticator of survival by multivariate analysis. Conclusions Vimentin expression by tumour cells provides important prognostic information for patients with localized RCC; the combination of vimentin expression and histological grade is a better predictor for survival than grade or vimentin expression alone.

Objectives To determine the interrelationship of histological grade and nuclear morphometry and to compare their prognostic significance in patients with localized renal cell carcinoma (RCC). Patients and methods A retrospective prognostic study of 39 patients with localized (pT1, pT2) RCC was performed. Conventional histological grade and nuclear morphometry were assessed independently and the correlation between these grading systems and their impact on the patients' outcome were evaluated. Results Histological grade and the nuclear morphometric variables were significantly correlated ; the strongest association was that between grade and the nuclear regularity factor. The best predictor of disease-free interval and survival (by univariate analysis) was the combination of nuclear area and nuclear elongation factor, followed by conventional tumour grade, nuclear elongation factor, nuclear regularity factor and nuclear area. However, a multivariate analysis showed that the only independent prognosticator for survival was the combination of nuclear area and nuclear elongation factor. Conclusions This study indicates that nuclear morphometry is prognostically superior to histological grade in patients with localized RCC.

In an attempt to identify a tumour marker, we investigated peripheral-type benzodiazepine binding sites (PBS) in kidney specimens obtained from patients who underwent nephrectomy due to a renal mass. [3H]PK 11195, an isoquinoline carboxamide derivative, was used as a ligand. Binding assays were conducted on samples of membrane homogenate taken from both the healthy portion and the tumour site of the kidney. It was found that binding characteristics of benign tumours and normal kidney tissues were not significantly different, i.e. equilibrium dissociation constants of 2.20 +/- 0.73 and 2.38 +/- 0.98 nM, respectively, and maximal number of binding sites of 3190 +/- 1081 and 4189 +/- 998 fmol/mg protein, respectively. In contrast, no PBS were detectable in renal carcinoma. The absence of PBS in malignant renal tissues may serve as a biochemical marker for tumours of the kidney.

Abces retroperitoneal multiloculaire s'etendant de la fosse iliaque a la zone perirenale ayant pour origine un appendice retrocaecal