Objective To investigate the association between tumour was no significant association between TMA and either tumour stage or grade. Division of cases according to vascularity and patient survival in a series of clearcell renal cell carcinoma (RCC), which often metastas-MMD ∏40 and >40 per HPF showed a significant diÂerence in survival curves between both groups, izes via the vascular route and frequently has a prominent vascular network.with a higher MMD being associated with longer patient survival. The significant association between Materials and methods Vessels were labelled in sections from 150 cases of clear cell RCC by factor VIII MMD and survival was retained for stage 3 tumours only when cases were stratified according to Robson's immunohistochemistry. The mean microvessel density (MMD), expressed as the number of vessels per 10 stage at presentation. TMA did not correlate with survival. high-power fields (HPFs, ×400, aggregate field area 1.452 mm2) and tumour microvessel area (TMA),Conclusions The assessment of tumour vascularity is of prognostic significance for clear cell RCC. The signifiexpressed as the percentage of the total tumour area within 10 HPFs, were measured for each case. The cant inverse relationship between MMD and patient survival suggests that for tumours with a poor progrelationship between MMD and TMA, tumour stage and grade, and patient survival over a 5-year follownosis, decreased MMD is associated with tumour fibrosis and the development of large diameter vascular up was determined. Results Tumour MMD ranged from 1 to 238 vessels per channels. Keywords Clear cell renal cell carcinoma, factor VIII, HPF, while the TMA was 1.2-60.8%. There was a weak but significant diÂerence for MMD between angiogenesis, tumour grade, tumour stage, prognosis tumour grades (P<0.01) and stages (P<0.05). There relation to papillary RCC [5], the association between

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Background. Although tumor staging is an important prognostic parameter for renal cell carcinoma (RCC), postnephrectomy survival interval is often difficult to predict for individual patients. This is the result of varied growth characteristics, which in tumors of similar stage govern both time to recurrence and rate of tumor dissemination. Polyclonal Ki‐67 antibody labels a proliferation‐specific antigen expressed in actively proliferating cells and is applicable to formalin fixed paraffin embedded archival tissue. This study was designed to test the prognostic utility of Ki‐67 antigen labeling in a series of RCC and to compare the data with those derived from other markers of cell proliferation. Methods. Polyclonal Ki‐67 antibody staining of 206 cases of RCC was undertaken using the streptavidin‐biotin method. Cases were grouped according to Ki‐67 indices and Kaplan‐Meier survival curves were constructed. Groups were compared in terms of survival for all cases and for each of Robson's stages using the log rank test. further sections were stained for proliferating cell nuclear antigen (PCNA) and silver‐staining nucleolar organizer regions (AgNORs). The prognostic significance of Ki‐67 antigen, PCNA and AgNOR staining, histologic grade, and tumor stage were compared using Cox's proportional hazard model. Results. Ki‐67 immunostaining was achieved for 173 cases with indices ranging from 0.1% to 30.4%. Division of tumors with indices 6% or less and greater than 6% showed a significant difference in survival between groups for all cases and for each Robson stage. Ki‐67 and PCNA indices, AgNOR scores, and tumor dissemination (Robson Stage 3 and 4) retained a significant association with survival on multivariate analysis. Conclusions. Polyclonal Ki‐67 antibody immunostaining provides significant survival information that complements that derived by other markers of cell proliferation and tumor staging. Cancer 1995;75:2714–9.

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