Fleming S, Griffiths D F R
University of Dundee, Ninewells Hospital, Dundee DD1 9SY, UK.
J Clin Pathol. 2005 Jan;58(1):7-14. doi: 10.1136/jcp.2003.014159.
Renal tumours constitute 2.5% of all malignancies and are among the 10 most common malignancies in the UK. Most of these are renal cell carcinomas (RCC) of various subtypes. Although historically RCC has been shown to be resistant to radiotherapy and chemotherapy, recent data suggest that the use of biological treatments, such as adjuvants, may be beneficial in patients with disease that has progressed at the time of presentation. The accurate diagnosis, staging, and grading of RCC is now a crucial element in optimal patient management. There are data to support the importance of histological type, tumour size, stage (especially patterns of extrarenal spread), and grade in determining outcome, and these data have been used to develop the published classification (Heidelberg/Rochester), staging (TNM), and grading (Fuhrman) systems. This article describes a dissection and histological sampling protocol that has been shown to increase the yield of staging information, a guide to histological classification and grading, and finally a minimum dataset for the completion of a satisfactory pathology report.
肾肿瘤占所有恶性肿瘤的2.5%，是英国最常见的10种恶性肿瘤之一。其中大多数是各种亚型的肾细胞癌（RCC）。尽管从历史上看，RCC已被证明对放疗和化疗有抗性，但最近的数据表明，使用生物治疗，如佐剂，可能对就诊时疾病已进展的患者有益。RCC的准确诊断、分期和分级现在是优化患者管理的关键要素。有数据支持组织学类型、肿瘤大小、分期（特别是肾外扩散模式）和分级在确定预后方面的重要性，这些数据已被用于制定已发表的分类（海德堡/罗切斯特）、分期（TNM）和分级（福尔曼）系统。本文描述了一种已被证明能提高分期信息获取率的解剖和组织学采样方案、组织学分类和分级指南，以及最后完成一份令人满意的病理报告所需的最小数据集。
