Ultrastructural Organization of Microcirculatory Bed in Clear Cell Renal Cell Car- cinoma of Different Grades of Differentiation
Journal Title: Lviv Clinical Bulletin - Year 2016, Vol 4, Issue 16
Abstract
Introduction. Implementing into medical practice target therapy in cancer patients including the conventional (clear cell) renal cell carcinoma (CCRCC) provides the delivery of anti-angiogenic and conventional cytoreductive agents through "normalized" ways of the vascular network of tumors to cancer cells. We also know that microcir- culatory bed and its microenvironment in tumors are formed by vasculogenesis and angiogenesis, unlike normal tissues, are characterized by the presence of primitive vessels and abnormal microenvironment. However, no studies were conducted, which would have characterized in comparative plan the ultrastructural organization of tumor microvessels in CCRCC of different grades of differentiation. The aim is to examine ultrastructural organization of microcirculatory bed in conventional (clear cell) renal cell carcinoma of different grades of differentiation. Materials and methods. Material for conducting transmission electron microscopic researches was postoperative biopsies of peripheral and central parts of tumors in CCRCC at high differentiated cancer (G 1) - three cases: one man (61-years-old) and two women (49- and 61-years-old); with an average grade of differentiation (G 2) – three cases: two men (43- and 66-years-old) and one woman (69-years-old); with a low grade of differentiation (G 3) – six cases, all were men (48-, 52-, 56-, 70-, 71-, 75-year-old). Material for conducting of сontrol studies in transmission electron microscopy was postoperative biopsies of renal cortex of eliminated parts of the kidney with tumor and the whole kidney with tumor in these patients with CCRCC. The technique is common in transmission electron microscopy. Results and discussion. At the ultrastructural level, vascular buds, primordial endothelial cells, optimally deve- loped capillaries, forming capillaries, already formed capillaries, small venules, primitive capillaries, hematopoietic cells, mesenchymal cells, fibers of collagen studied in peripheral stroma of tumors with high differentiated (G 1) CCRCC. In the central part of the tumors there are small numbers of cells that are in the process of apoptosis, de- composition and necrosis. Gaps of disorganized capillaries are rich in accumulations of erythrocytes, platelets and fibrin monomer bundles of fibers, gaps of small venules with wrinkled walls are rich in a homogenous blood plasma. The sclerotized stroma of tumors with an average grade of differentiation (G 2) CCRCC contains mesenchymal cells, disorganized bands of primordial endothelial cells, hypertrophic capillaries and small venules. The luminal surfaces of endothelial cells of the vessels are formed by a large number of microvilli. Their gaps contain hyperag- gregates of erythrocytes, polymorphonuclear granulocytes, monocytes, platelets with high electron density, fibrin polymer bundles of fibers, the large drops of lipoprotein. At the low grade of differentiation (G 3) CCRCC, the considerable areas of epithelium- and endothelium-con- taining formations of peripheral and more central parts of the tumor are disorganized, and are in a state of apoptosis and necrosis. It was observed that the modified tumor apoptotic epithelial cells with surrounding fibrin polymer bundles of fibers and adjacent the remodulated stroma were rich in mononuclear cells, monocytes, hematopoietic cells, mesenchymal cells, primordial endothelial cells, vascular buds, capillaries of sinusoidal type, primitive capillaries, newly formed capillaries and small venules. The control studies made it possible to establish that the ultrastructural organization of optimally developed capillaries of peripheral part of tumors with high differentiated grade CCRCC is close to that of peritubular capil- laries of renal cortex of patients with high differentiated (G 1) CCRCC and kidney of mammals. Conclusions. The ultrastructure of microcirculatory bed of tumors with a high grade of differentiation (G 1) is a more "normalized" than the average one (G 2) and the low (G 3) grade of differentiation CCRCC.
Authors and Affiliations
С. В. Федевич
Keywords
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- EP ID EP219015
- DOI 10.25040/lkv2016.04.027
- Views 138
- Downloads 0
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