Gillett Michael D, Cheville John C, Karnes R Jeffrey, Lohse Christine M, Kwon Eugene D, Leibovich Bradley C, Zincke Horst, Blute Michael L
Division of Urology, Southern Illinois University, Springfield, Illinois, USA.
J Urol. 2005 Jun;173(6):1893-6. doi: 10.1097/01.ju.0000158157.57981.80.
We compared histological subtype, pathological features and outcome of patients with solid renal masses who were 18 to 40 years old vs patients who were 60 to 70 years old.
We conducted a retrospective review of the Mayo Clinic Nephrectomy Registry from 1970 to 2000, and identified 124 patients 18 to 40 years old and 1,067 patients 60 to 70 years old available for analysis.
There was no significant difference in the incidence of benign solid renal masses between patients 18 to 40 years old and those 60 to 70 years old (13.7% vs 10.2%). Among patients with renal cell carcinoma (RCC), younger patients were more likely to have chromophobe RCC (13.1% vs 3.6%) and less likely to have clear cell RCC (70.1% vs 81.5%) than older patients. Among patients with clear cell RCC, younger patients were more likely to have stage pT2b or lower tumors (82.7% vs 69.9%) and a higher incidence of cystic clear cell RCC (10.7% vs 2.2%) than older patients. Younger patients had an improved cancer specific survival compared with older patients but this difference was not statistically significant (risk ratio 0.71, p =0.127).
We found that patients 18 to 40 years old were more likely to have chromophobe and less likely to have clear cell RCC compared with patients 60 to 70 years old. We did not identify a higher incidence of papillary RCC in younger patients. Patients with clear cell RCC 18 to 40 years old had a higher incidence of low stage and cystic tumors compared with patients 60 to 70 years old, features which have been shown to have a favorable prognosis. These factors likely contributed to improved cancer specific survival for younger patients.
我们比较了18至40岁与60至70岁实性肾肿块患者的组织学亚型、病理特征及预后。
我们对梅奥诊所1970年至2000年的肾切除术登记资料进行了回顾性分析，确定了124例18至40岁以及1067例60至70岁可供分析的患者。
18至40岁患者与60至70岁患者的良性实性肾肿块发生率无显著差异（分别为13.7%和10.2%）。在肾细胞癌（RCC）患者中，年轻患者比老年患者更易患嫌色性RCC（分别为13.1%和3.6%），而患透明细胞RCC的可能性较小（分别为70.1%和81.5%）。在透明细胞RCC患者中，年轻患者比老年患者更易患pT2b期或更低分期的肿瘤（分别为82.7%和69.9%），且囊性透明细胞RCC的发生率更高（分别为10.7%和2.2%）。与老年患者相比，年轻患者的癌症特异性生存率有所提高，但差异无统计学意义（风险比0.71，p = 0.127）。
我们发现，与60至70岁的患者相比，18至40岁的患者更易患嫌色性RCC，而患透明细胞RCC的可能性较小。我们未发现年轻患者中乳头状RCC的发生率更高。与60至70岁的患者相比，18至40岁的透明细胞RCC患者低分期和囊性肿瘤的发生率更高，这些特征已被证明预后良好。这些因素可能有助于提高年轻患者的癌症特异性生存率。
