Hoffmann Nathan E, Gillett Michael D, Cheville John C, Lohse Christine M, Leibovich Bradley C, Blute Michael L
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
J Urol. 2008 Feb;179(2):474-7. doi: 10.1016/j.juro.2007.09.036.
The majority of the published data regarding the rates of renal cell carcinoma metastasis to specific locations has examined renal cell carcinoma as a whole. We evaluated site of distant metastasis by renal cell carcinoma histological subtype.
We studied 910 patients treated with radical nephrectomy for clear cell, papillary or chromophobe renal cell carcinoma at the Mayo Clinic between 1970 and 2000 who had distant metastasis at nephrectomy or who had metastasis during followup. The sites of metastases were compared by histological subtype using the chi-square and Fisher exact tests.
There were 853 (94%) patients with clear cell, 39 (4%) with papillary and 18 (2%) with chromophobe renal cell carcinoma. Median followup for the 65 patients who were still alive at last followup was 11.6 years. Patients with clear cell renal cell carcinoma were more likely to have metastasis to the lungs (53.6%) compared to those with papillary (33.3%) and chromophobe (33.3%) renal cell carcinoma (p = 0.012). Patients with chromophobe renal cell carcinoma were more likely to have metastasis to the liver compared to those with clear cell renal cell carcinoma (33.3% vs 9.7%, p = 0.007), but there was not a statistically significantly difference in the incidence of liver metastases between patients with chromophobe and papillary renal cell carcinoma (33.3% vs 18.0%, p = 0.308).
Site of distant metastasis varies significantly by renal cell carcinoma histological subtype. Patients with clear cell renal cell carcinoma are more likely to have metastasis to the lungs while patients with chromophobe renal cell carcinoma are more likely to experience liver metastasis.
大多数已发表的关于肾细胞癌转移至特定部位发生率的数据都是将肾细胞癌作为一个整体进行研究的。我们按肾细胞癌的组织学亚型评估远处转移部位。
我们研究了1970年至2000年间在梅奥诊所接受根治性肾切除术的910例透明细胞、乳头状或嫌色性肾细胞癌患者，这些患者在肾切除时已有远处转移或在随访期间发生转移。采用卡方检验和Fisher精确检验按组织学亚型比较转移部位。
有853例（94%）透明细胞癌患者，39例（4%）乳头状癌患者，18例（2%）嫌色性肾细胞癌患者。最后一次随访时仍存活的65例患者的中位随访时间为11.6年。与乳头状（33.3%）和嫌色性（33.3%）肾细胞癌患者相比，透明细胞肾细胞癌患者更易发生肺转移（53.6%）（p = 0.012）。与透明细胞肾细胞癌患者相比，嫌色性肾细胞癌患者更易发生肝转移（33.3%对9.7%，p = 0.007），但嫌色性和乳头状肾细胞癌患者之间肝转移发生率无统计学显著差异（33.3%对18.0%，p = 0.308）。
肾细胞癌远处转移部位因组织学亚型不同而有显著差异。透明细胞肾细胞癌患者更易发生肺转移，而嫌色性肾细胞癌患者更易发生肝转移。
