الفهرس 
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Abstract
This is a retrospective study. It was done on 50 samples of different types of renal cell carcinoma (clear cell, papillary and chromophobe) collected from Pathology Department and Early Cancer Detection Unit, Faculty of Medicine, Benha University (2018 &2019) to evaluate the expression of CXCR4 in those 3 histopathological types of renal cell carcinoma and to correlate the findings with the clinical and pathological findings. This study carried out on two positive control cases: normal kidney tissue and breast carcinoma. Three scoring methods were applied to assess CXCR4 expression in RCC tissues, (the intensity, the extent and H score). The pattern of CXCR4 expression was categorized according to its localization either membranous with or without cytoplasmic staining (M+C) or nuclear with or without cytoplasmic staining (N+C). Among 50 RCC studied cases, 28 cases (56%) were of clear cell type, 11 cases (22%) were of papillary, and 11 cases (22%) were of chromophobe type. Out of the studied cases, 35 (70%) of all cases were male and 15 (30%) of them were female. There is a clear predominance of men among patients with RCC. Cases of clear and papillary types were graded according to Fuhrman grading system into 4 grades. They were classified into low grade (GI&II) and high grade (III&IV). Low grade (GI&II) Papillary type were 45.5% and (53.6%) of clear type were of low grade (grade I and II). High grade tumors were 54.5% of papillary type and (46.4%) of clear type. The majority of chromophobe cases (90.9%) were of low grade (grade I and II) and only one case (9.1%) was of high grade (grade III). Staging of RCC cases in this study were classified according to TNM staging system into 3 stages. Most of RCC cases were of low stage, 64.3% of clear type and 72.7% papillary type (stage I and II). Also, most cases of chromophobe type (90.9%) were of (stage I and II) and only one case (9.1%) was of high stage (stage III). There was a statistically significant correlation between the grade and the stage of clear and papillary types. There was also a statistically significant correlation between the grade and stage of chromophobe type. Tumor size was categorized in this study into four groups: ≤4 cm, 4-7cm, >7–10 cm, and ≥10 cm. The median tumor size of the studied cases was 10 cm. In the present work, there was a statistically significant correlation between histopathological types and the size of the tumor.Also, there was a highly statistically significant correlation between the grade and the size of clear and papillary types. There was also a highly statistically significant correlation between grade and size of chromophobe type.In the current study, there was a highly statistically significant correlation between the stage and the size of renal cell carcinoma cases.In this study, there was a significant correlation between histopathological types and MVI. At the present work, there was a statistically significant correlation between the grade and MVI of all renal cell carcinoma cases. In this study, there was a statistically significant correlation between histopathological types and the pattern of CXCR4 expression. There was significant correlation between histopathological types and the extent of CXCR4 expression. There was significant relationshipe between histopathological types and the CXCR4 intensity. Most of RCC cases of clear type (67.9%) and papillary type (72.8%) showed either intermediate or strong CXCR4 expression, however most of chromophobe cases showed either weak or intermediate (91%) CXCR4 expression. In the current study, histopathological types had a significant correlation with H score. Out of clear cell RCC cases, 19 cases (68%) showed low H score and 9 cases (32%) showed high H score. Out of papillary cell RCC cases, 8 cases (73%) showed low H score and 3cases (27%) showed high H score. Out of chromophobe RCC cases, 10 cases (90.9%) showed low H score and 1 case (9.1%) showed high H score. In the present study, there was significant correlation between the size of the tumor and the pattern of CXCR4 expression. Most of cases showed (M+C) pattern (86.2%) were < 7cm, while most of cases showed (N+C) pattern (90.5%) were >7cm. There was a highly statistically significant correlation in the current study between the size of the tumor and the extent of CXCR4 expression. There was a highly significant correlation between the size of the tumor and the CXCR4 intensity.In the present work, H score and tumor size were positively correlated. There was a highly significant correlation between grade renal cell carcinoma types and the pattern of CXCR4 expression. In the present study, there was a significant correlation between the grade of renal cell carcinoma and the extent of CXCR4 expression.There was a statistically significant correlation between the grade of renal cell carcinoma cases and CXCR4 intensity. In the present study, there was a statistically significant correlation between the grade of renal cell carcinoma cases and H score of CXCR4. In the current work, there was significant correlation between renal cell carcinoma stage and the extent and pattern of CXCR4 expression. There was a statistically significant correlation between renal cell carcinoma stage and CXCR4 intensity. In the current work, there was significant correlation between MVI and the pattern of CXCR4 expression. In this study, there was a statistically significant correlation between MVI and the extent of CXCR4 expression. Also, there was a statistically significant correlation between MVI and CXCR4 intensity and H score of expression.