[812] Immunohistochemical Profile of Renal Cell Carcinoma in Patients Younger than 45 Years of Age: Analysis of 87 Cases of Different Tumor Subtypes

Ryan Carr, Guoping Cai, Yunhua Bao, Manju L Prasad, Satish K Tickoo, Adebowale J Adeniran. Yale University School of Medicine, New Haven, CT

Background: Renal Cell Carcinoma (RCC) is distinctly rare in children and young adults. Because of the rarity of the tumor in this age group, the immunohistochemical profile has not been fully described. The goal of this study is to define the immunohistochemical profile of the various subtypes of RCC in patients aged 45 and younger.
Design: A tissue microarray block with 87 cases of RCC (49 clear cell [CRCC], 23 papillary (PRCC), 10 Chromophobe [ChRCC] and 5 translocation-associated [TxRCC]) was constructed. The tumors were stained with the following diagnostic antibodies: cytokeratin (CK) AE1/AE3, CK7, CK903, TFE3, TFEB, CD10, AMACR, C-KIT, Vimentin, EMA, CA-IX; and with the following prognostic antibodies: PAX-8, survivin and VHL. The slides were reviewed and a stain was deemed to be positive if it demonstrated moderate to strong intensity in more than 5% of the tumor cells.
Results: Results of the immunohistohistochemical stains are listed in Table 1.

Table 1: Results of Immunohistochemical stains
 CRCCPRCCChRCCTxRCC
AE1/AE345/4923/236/101/5
TFE30/490/230/105/5
TFEB0/490/230/100/5
CD1038/4910/237/104/5
AMACR17/4923/231/102/5
C-KIT1/491/238/100/5
CK9034/499/230/100/5
Vimentin49/4923/232/105/5
CK716/4918/239/100/5
EMA31/4918/2310/101/5
CA-IX34/494/230/100/5
PAX-821/4917/232/102/5
Survivin39/4918/239/102/5
VHL17/494/2310/102/5


The overall profiles of the different tumor types are listed in Table 2.

Table2: Immunohistochemical Profile
Tumor typeImmunohistochemical profile
CRCCAE1/AE3, Vimentin, CD10, EMA, CA-IX positive; PAX-8 variable; C-KIT, CK903 negative
PRCCAE1/AE3, AMACR, Vimentin, CK7, EMA, PAX-8 positive; C-KIT, CA-IX, negative
ChRCCAE1/AE3, CD10, C-KIT, CK7, EMA positive; AMACR, Vimentin, CK903, CA-IX, PAX-8 negative
TxRCCTFE3, CD10, Vimentin positive; AE1/AE3, C-KIT, CK903, CK7, CA-IX negative



Conclusions: There is a significant overlap between the immunoprofile of RCC subtypes in patients aged 45 and younger and that in RCC subtypes in older patients. PAX-8 is expressed by a significant proportion of PRCC and variable proportions of the other subtypes, with a distinctive nuclear staining pattern. Survivin is expressed in a significant proportion of all RCC subtypes while VHL is highly expressed in ChRCC and variably in all other subtypes. The significance of this finding is uncertain, as further work needs to be done to determine the prognostic significance of these markers on the various subtypes of RCC.
Category: Genitourinary (including renal tumors)

Tuesday, March 20, 2012 9:30 AM

Poster Session III # 148, Tuesday Morning

 

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