Objective To determine the clinicopathological characteristics of histologically defined papillary renal cell carcinoma (RCC) in relation to prognosis. Patients and methods In total, 768 patients with RCC underwent nephrectomy at our university hospital between 1957 and 1995. RCC was classified into clear‐cell carcinoma in 689 patients (89.7%, no follow‐up in 14), chromophobe cell carcinoma in 36 (4.7%, no follow‐up in two) and papillary RCC in 43 (5.6%, no follow‐up in one). In the present study, the 42 patients with papillary RCC who underwent nephrectomy and were followed up were those in whom the clinicopathological features of the papillary RCC were assessed. Factors assessed were the presence or absence of foam‐cell infiltration, occurrence of bleeding and/or necrosis, presence or absence of a pseudocapsule, mixed occurrence with clear‐cell carcinoma, presence or absence of solid variants, cytoplasmic appearance (basophilic vs eosinophilic cells), stage, nuclear grade of malignancy, and angiographic appearance in relation to prognosis. The prognosis was also compared among patients with clear‐cell, chromophobe cell and papillary RCC. Results The prognosis was significantly better in patients with foam‐cell infiltration (P=0.03), with a pseudocapsule (P=0.07), with no solid variants (P=0.001) and with basophilic cells (P<0.001). There were also significant differences in survival between patients with low‐stage (1+2) and high‐stage (3+4) disease (P=0.003), and among grades 1–3 (grade 1 vs 2, P=0.05; grade 1 vs 3, P<0.001, grade 2 vs 3, P=0.006). Furthermore, the prognosis in patients with papillary RCC was worse than in those with chromophobe cell carcinoma (P=0.02), but there was no significant difference in survival between patients with papillary RCC and those with clear‐cell carcinoma. Conclusion The clinicopathological features (e.g. the presence or absence of foam cells, of a pseudocapsule and of solid variants, cytoplasmic appearance, and the stage and nuclear grade of malignancy) are important prognostic factors for patients with papillary RCC. Furthermore, the prognosis in patients with papillary RCC is similar to those with clear‐cell carcinoma.

Objective To assess the immunological relationship whom showed a higher level than the mean, and IL-6 was produced in 32 (91%) of whom 10 (29%) showed between tumour and host, focusing on the production of T-cell helper (Th) subset-derived cytokines in a higher level than the mean. IL-10 was detected in 28 patients (80%) of whom 14 (40%) showed a higher patients with renal cell carcinoma (RCC). Patients and methods The study comprised 35 patients level than the mean. The production of these cytokines was closely related to the stage and grade of malig-(19 men and 16 women, mean age 56.9 years, range 39-78) with RCC, who had undergone nephrectomy.nancy. Furthermore, there were significant correlations between the levels of production of IL-4 and Using enzyme-linked immunosorbent assays, the levels of Th1-derived cytokines were measured, including IL-5 (r2=0.92), IL-4 and IL-10 (r2=0.91), and IL-5 and IL-10 (r2=0.85). interleukin (IL)-2 and interferon (IFN)-c, and Th2-derived cytokines, including IL-4, IL-5, IL-6, Conclusion The intratumoral immunological environment in patients with RCC shows a tendency to IL-10 and others. Results There was no detectable IL-2 or IFN-c proproduce Th2-related cytokines in accordance with the stage and grade; this suggests a role in humoral but duction (below the detection limit) except in two patients; IL-4 was produced in 18 patients (51%) and not in cellular immunity. Keywords Renal cell carcinoma, immunity, T helper of these, 15 (43%) showed a higher level than the mean. IL-5 was produced in 12 patients (34%), all of subset, cytokine cytokines in patients with RCC. Based upon the results,