Lohse Christine M, Cheville John C
Division of Biostatistics, Mayo Clinic, Rochester, MN 55905, USA.
Clin Lab Med. 2005 Jun;25(2):433-64. doi: 10.1016/j.cll.2005.01.013.
Accurate subtyping of RCC is critically important and should be considered in algorithms that are developed as prognostic tools for the patient and clinician. The TNM classification, already a powerful prognostic factor, will continue to evolve. The authors recommend that each component of the classification be assessed and reported during pathologic examination. This article also highlighted the importance of assigning a nuclear grade that is based on standardized and reproducible criteria that reflect the heterogeneity of nuclear and nucleolar features within RCC. Lastly, it is increasingly evident that coagulative tumor necrosis and sarcomatoid differentiation are compelling prognostic factors, on par with nuclear grade, and should be assessed routinely. To conclude, the complete list of pathologic features that are evaluated as part of the Mayo Clinic Nephrectomy Registry is presented. The features that are reported routinely in clinical practice also are indicated; this can serve as a guide for the reporting of results from the pathologic examination of RCC.
肾细胞癌（RCC）的准确亚型分类至关重要，在作为患者和临床医生预后工具而开发的算法中应予以考虑。TNM分类已是一个强大的预后因素，还将继续发展。作者建议在病理检查期间对分类的每个组成部分进行评估和报告。本文还强调了根据反映RCC内核和核仁特征异质性的标准化且可重复的标准来确定核分级的重要性。最后，越来越明显的是，凝固性肿瘤坏死和肉瘤样分化与核分级一样，是令人信服的预后因素，应常规进行评估。总之，列出了作为梅奥诊所肾切除术登记处一部分进行评估的完整病理特征清单。还指出了临床实践中常规报告的特征；这可作为RCC病理检查结果报告的指南。
