Gimbergues P, Guy L, Costes-Charlet N, Kwiatowsky F, Kemeny J L, Boiteux J P
Service d'Urologie, Hôpital Gabriel Montpied, Clermont-Ferrand, France.
Prog Urol. 1999 Dec;9(6):1039-45.
To assess the prognostic value of Führman's nuclear grade and to compare it to various clinical and histological prognostic factors of renal carcinomas.
Single-centre retrospective study of 102 patients operated for renal tumours between January 1985 and December 1990 (mean follow-up: 8.2 years). Prognostic assessment was studied from survival curves.
The prognostic factors most closely correlated with survival were, in decreasing order, metastatic invasion, nuclear grade, stage of local extension and lymph node invasion. A significant (p < 0.01) survival difference was only observed between Führman grade 2 and grade 3 tumours. This difference was accentuated (p < 0.001) when grade 1 and 2 tumours were compared to grade 3 and 4 tumours. Führman's nuclear grade is independent of the side affected, the tumour volume, its multifocal nature, microscopic venous invasion and metastatic invasion at the time of diagnosis. Führman's nuclear grade is correlated with invasion of fat, the presence of a contingent of eosinophilic cells, stage of local extension, lymph node invasion and the subsequent development of metastases.
This study confirms the importance of Führman's nuclear grade among the various prognostic factors of renal carcinomas and quantifies its value with respect to other prognostic factors.
评估福尔曼核分级的预后价值，并将其与肾癌的各种临床和组织学预后因素进行比较。
对1985年1月至1990年12月间接受肾肿瘤手术的102例患者进行单中心回顾性研究（平均随访时间：8.2年）。通过生存曲线研究预后评估。
与生存最密切相关的预后因素依次为转移侵袭、核分级、局部扩展阶段和淋巴结侵袭。仅在福尔曼2级和3级肿瘤之间观察到显著的（p < 0.01）生存差异。当将1级和2级肿瘤与3级和4级肿瘤进行比较时，这种差异更加明显（p < 0.001）。福尔曼核分级与受影响的侧别、肿瘤体积、多灶性、诊断时的显微镜下静脉侵袭和转移侵袭无关。福尔曼核分级与脂肪侵袭、嗜酸性细胞群的存在、局部扩展阶段、淋巴结侵袭以及随后转移的发生相关。
本研究证实了福尔曼核分级在肾癌各种预后因素中的重要性，并量化了其相对于其他预后因素的价值。
