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Eur J Pediatr Surg
DOI: 10.1055/s-0044-1791846
Original Article

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

Mingchuan Huang   *
1   Department of Pediatric Surgery, Sun Yat-sen University First Affiliated Hospital, Guangzhou, People's Republic of China
,
Man Shu   *
2   Department of Pathology, Sun Yat-sen University First Affiliated Hospital, Guangzhou, People's Republic of China
,
Zhe Xu   *
1   Department of Pediatric Surgery, Sun Yat-sen University First Affiliated Hospital, Guangzhou, People's Republic of China
,
Lin Wang
3   Guangzhou KingMed Diagnostics Laboratory Group Co Ltd, Guangzhou, People's Republic of China
,
Longshan Liu
4   Organ Transplant Center, Sun Yat-sen University First Affiliated Hospital, Guangzhou, People's Republic of China
,
Juncheng Liu
1   Department of Pediatric Surgery, Sun Yat-sen University First Affiliated Hospital, Guangzhou, People's Republic of China
,
Huanxi Zhang
4   Organ Transplant Center, Sun Yat-sen University First Affiliated Hospital, Guangzhou, People's Republic of China
,
Shicong Yang   #
2   Department of Pathology, Sun Yat-sen University First Affiliated Hospital, Guangzhou, People's Republic of China
,
Changxi Wang   #
4   Organ Transplant Center, Sun Yat-sen University First Affiliated Hospital, Guangzhou, People's Republic of China
5   Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Sun Yat-sen University First Affiliated Hospital, Guangzhou, People's Republic of China
6   Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), Sun Yat-sen University First Affiliated Hospital, Guangzhou, People's Republic of China
,
Pengfei Gao   #
1   Department of Pediatric Surgery, Sun Yat-sen University First Affiliated Hospital, Guangzhou, People's Republic of China
4   Organ Transplant Center, Sun Yat-sen University First Affiliated Hospital, Guangzhou, People's Republic of China
› Institutsangaben Funding This study was supported by National Natural Science Foundation of China (81870511, 82170770), Guangdong Provincial Key Laboratory on Organ Donation and Transplant Immunology (2017B030314018, 2020B1212060026), Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation, 2020A0505020003), Science and Technology Planning Project of Guangzhou City (201903010058, 202201011318), Major Clinical Technology Project of Guangzhou City (2023P-ZD15), Elite Talent Project of Guangdong Province (R09002), Natural Science Foundation of Guangdong Province (22140500001368) and Medical Science and Technology Research Foundation of Guangdong Province (A2024298).
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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.

Keywords

Wilms tumor - non-neoplastic renal parenchyma - nephrogenic rests - nephron-sparing surgery

* These authors have contributed equally to this work and share first authorship.


# Shicong Yang, Changxi Wang and Pengfei Gao serve as co-corresponding authors. The first corresponding author is Pengfei Gao.




Publikationsverlauf

Eingereicht: 21. Mai 2024

Angenommen: 25. September 2024

Artikel online veröffentlicht:
18. Oktober 2024

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