Wang Zhi-hua, DU Li-huan, Hu Zhi-quan, Chen Xian-guo, Zhao Xia, Wang Shao-gang, Zhuang Qian-yuan, Ye Zhang-qun
Department of Urology, Tongji Medical College of Hua Zhong University of Science and Technology, Wuhan 430030, China.
Zhonghua Wai Ke Za Zhi. 2011 Apr 1;49(4):320-3.
To explore the clinical, pathological features and prognosis of patients with chromophobe renal cell carcinoma.
From January 1998 to January 2008, clinical data of 29 patients with chromophobe renal cell carcinoma including clinical manifestations, imaging examinations, treatment models, pTNM stages and follow-up results, were summarized to investigate its features and prognosis.
All cases had no obvious clinical and preoperative imaging presentation. There were 23 patients underwent radical nephrectomy, and 6 cases underwent nephron sparing surgery. Postoperative pathological findings confirmed the diagnosis of chromophobe renal cell carcinoma. Macroscopically, the cut surface of the tumors were generally beige in color. Histologically, it showed polygonal chromophobe cells and small round eosinophilic cells with eccentric hyaline degeneration. These tumor cells had a clear and sharp membrane, lightly stained abundant cytoplasm with a fine reticular translucent pattern and irregular nuclei. And a perinuclear halo was often seen in these cells. Histochemically, the tumor cells generally show a diffuse and strong reaction for CK-8 with a negative expression of Vimentin. The pTNM stages of the tumor were as follows, pT1N0M0 in 11 cases, pT2N0M0 in 8 cases, pT3aN0M0 in 5 cases, pT1N1M0 in 3 cases, pT2N1M0 in 2 cases. Twenty-six cases of patients were followed up (24 to 144 months, with an average of 90 months), 3 cases died of cardio-cerebrovascular disease, and local recurrence involved in 6 cases with reoperation in 4 cases, as well as distant metastasis in 1 case. Twenty-one cases survived with tumor-free. The statistical results indicated that the survival rates of the patients with chromophobe renal cell carcinoma in five years and ten years were 83.9%, 77.9%, respectively, compared with renal cell carcinoma of the same stage 63.8% and 49.9% at the same periods, and there is no difference in the survival rate of five years (P > 0.05) but significant difference in that of ten years (P < 0.01).
Chromophobe renal cell carcinoma is a morphologically uncommon subtype of renal cell carcinoma with the good prognosis. Definite diagnosis depends on its typical pathological feature. Radical nephrectomy is the first choice for the treatment of chromophobe renal cell carcinoma.
探讨嫌色性肾细胞癌患者的临床、病理特征及预后。
总结1998年1月至2008年1月间29例嫌色性肾细胞癌患者的临床资料，包括临床表现、影像学检查、治疗方式、pTNM分期及随访结果，以研究其特征及预后。
所有病例术前均无明显临床及影像学表现。23例行根治性肾切除术，6例行保留肾单位手术。术后病理检查确诊为嫌色性肾细胞癌。大体上，肿瘤切面一般呈米色。组织学上，显示多边形嫌色细胞及小圆形嗜酸性细胞，伴有偏心性透明变性。这些肿瘤细胞有清晰的细胞膜，胞质丰富淡染，呈细网状半透明模式，核不规则。这些细胞常可见核周晕。免疫组化上，肿瘤细胞一般对CK - 8呈弥漫性强反应，波形蛋白表达阴性。肿瘤的pTNM分期如下：pT1N0M0 11例，pT2N0M0 8例，pT3aN0M0 5例，pT1N1M0 3例，pT2N1M0 2例。26例患者进行了随访（24至144个月，平均90个月），3例死于心脑血管疾病，6例局部复发，4例再次手术，1例远处转移。21例无瘤生存。统计结果表明，嫌色性肾细胞癌患者5年和10年生存率分别为83.9%、77.9%，同期同分期肾细胞癌5年和10年生存率分别为63.8%和49.9%，5年生存率无差异（P>0.05），但10年生存率有显著差异（P<0.01）。
嫌色性肾细胞癌是肾细胞癌中形态学上不常见的亚型，预后良好。明确诊断依赖于其典型的病理特征。根治性肾切除术是治疗嫌色性肾细胞癌的首选。
