Onishi T, Oishi Y, Goto H, Tomita M, Abe K, Sugaya S
Department of Urology, Jikei University School of Medicine, Tokyo, Japan.
Int J Urol. 2001 Jun;8(6):268-74. doi: 10.1046/j.1442-2042.2001.00298.x.
No consistent clinicopathologic characteristics of cyst-associated renal cell carcinoma (CRCC) have previously been determined.
In total, 768 patients with renal cell carcinoma (RCC) underwent radical or partial nephrectomy. Renal cell carcinoma was classified as CRCC in 27 of these patients (3.5%, subdivided into RCC originating in a cyst and cystic RCC), clear-cell RCC in 662 patients (86.2%), chromophobe cell renal carcinoma in 36 patients (4.7%) and papillary RCC in 43 patients (5.6%) according to the criteria of the World Health Organization.
The pathologic stage and nuclear grade were usually lower in those with CRCC (low stage/low grade; 89%/96%) or chromophobe cell renal carcinoma (low stage/low grade; 89%/80%) than in those with clear-cell RCC (low stage/low grade; 59%/65%) or papillary RCC (low stage/low grade; 53%/69%). Of the 27 CRCC patients, only 19 (70%) could be diagnosed through preoperative imaging studies. Patients with CRCC showed a favorable prognosis (survival rate: 95% at 1 year, 89.7% at 3 years and 84.4% thereafter) and, especially among the patients with RCC originating in a cyst, no cancer-related death was observed. Comparing the survival among four types of RCC, a favorable outcome was observed in cases of CRCC or chromophobe cell renal carcinoma compared with clear-cell RCC or papillary RCC (clear vs chromophobe: P = 0.002; chromophobe vs papillary: P = 0.019; clear vs cyst-associated: P = 0.001; papillary vs cyst-associated: P = 0.00079).
In cases of CRCC, the disease was usually detected at lower stages and grades and therefore the prognosis was better than in cases of other types of RCC. Preoperative diagnosis of this disease was very difficult, especially in cases of RCC originating in a cyst.
此前尚未确定囊肿相关性肾细胞癌（CRCC）一致的临床病理特征。
共有768例肾细胞癌（RCC）患者接受了根治性或部分肾切除术。根据世界卫生组织的标准，这些患者中27例（3.5%，细分为起源于囊肿的RCC和囊性RCC）被归类为CRCC，662例（86.2%）为透明细胞RCC，36例（4.7%）为嫌色细胞肾细胞癌，43例（5.6%）为乳头状RCC。
CRCC患者（低分期/低分级；89%/96%）或嫌色细胞肾细胞癌患者（低分期/低分级；89%/80%）的病理分期和核分级通常低于透明细胞RCC患者（低分期/低分级；59%/65%）或乳头状RCC患者（低分期/低分级；53%/69%）。27例CRCC患者中，仅19例（70%）可通过术前影像学检查确诊。CRCC患者预后良好（生存率：1年时为95%，3年时为89.7%，此后为84.4%），尤其是在起源于囊肿的RCC患者中，未观察到与癌症相关的死亡。比较四种类型RCC的生存率，与透明细胞RCC或乳头状RCC相比，CRCC或嫌色细胞肾细胞癌患者的预后良好（透明细胞与嫌色细胞：P = 0.002；嫌色细胞与乳头状：P = 0.019；透明细胞与囊肿相关性：P = 0.001；乳头状与囊肿相关性：P = 0.00079）。
在CRCC病例中，疾病通常在较低分期和分级时被发现，因此预后优于其他类型的RCC。该疾病的术前诊断非常困难，尤其是在起源于囊肿的RCC病例中。
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