对采用肾窦完全封闭的加的夫肾切除术切开方案的评估：对肿瘤分期的影响及实际问题
Assessment of the Cardiff nephrectomy cut-up protocol with total blocking of the renal sinus: effect on tumour staging and practical issues.
作者信息
Soilleux E J, Roberts I S D
机构信息
Department of Cellular Pathology, John Radcliffe Hospital, Headington, Oxford, UK.
出版信息
J Clin Pathol. 2006 Nov;59(11):1209-11. doi: 10.1136/jcp.2005.034793.
AIM
To evaluate the effects on detection of vascular invasion and workload of a new standard dissection protocol for examining nephrectomy specimens for renal cell carcinoma.
METHODS
Using 192 consecutive renal cell carcinoma nephrectomy specimens, the incidence of vascular invasion and number of tissue blocks per tumour were compared before and after introduction of the new protocol.
RESULTS
The Cardiff protocol increased the percentage of tumours staged as T3b (renal sinus or hilar vein invasion) from 37.7% to 55.7% cases (p<0.001), with an increase from 9.1% to 21.7% of those staged as T3b due to renal sinus vein invasion alone (p<0.01). A small, but significant, permanent increase in workload was observed from an average of 11.7 to 13.4 blocks per case (p<0.001).
CONCLUSIONS
This protocol is suitable for use in routine practice to evaluate pathological prognostic determinants important for clinical management, while causing only a small increase in workload.
目的
评估一种用于检查肾细胞癌肾切除标本的新标准解剖方案对血管侵犯检测及工作量的影响。
方法
使用192例连续的肾细胞癌肾切除标本，比较新方案引入前后血管侵犯的发生率及每个肿瘤的组织块数量。
结果
卡迪夫方案使分期为T3b（肾窦或肾静脉侵犯）的肿瘤百分比从37.7%增至55.7%（p<0.001），仅因肾窦静脉侵犯而分期为T3b的比例从9.1%增至21.7%（p<0.01）。观察到工作量有小幅但显著的永久性增加，从平均每例11.7个组织块增至13.4个（p<0.001）。
结论
该方案适用于常规实践，以评估对临床管理重要的病理预后决定因素，同时仅使工作量有小幅增加。
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