Ghoneim T P, Ouzzane A, Leroy X, Lemaitre L, Berthon N, Fantoni J-C, Villers A, Zini L
Service d'urologie, université de Lille Nord-de-France, hôpital Claude Huriez, CHU de Lille, 2, rue Michel-Polonovski, 59000 Lille, France.
Prog Urol. 2012 Feb;22(2):93-9. doi: 10.1016/j.purol.2011.11.007. Epub 2012 Jan 4.
Clinical and pathological characteristics of renal cell carcinoma (RCC) of patients younger than 40 years old are not well known. The objective of this study was to analyze these characteristics by comparison to a group of patients aged 58 to 62.
Retrospective study of a group of patients aged less than 40 years old (group 1, n=44) and a group of patients aged 58 to 62 years old (group 2; n=106) treated surgically for a renal mass from January 2000 to July 2009. A comparative analysis of clinical, pathological characteristics and of cancer-specific survival was performed. Specific survival was calculated with the Kaplan-Meier method and compared with the Log-Rank test. Univariate and multivariable analysis were performed to assess and quantify the effect of age on cancer-specific survival. Covariates were gender, age group, tumor size, pT stage, histological sub-type and Fuhrman grade.
Clinical and pathological characteristics were similar in both groups (P>0.05) except for histological sub-type (56% of clear cell RCC for group 1 versus 82% for group 2). In the group of patients younger than 40 years, translocation RCC represented 23% of all RCCs. Cancer-specific survival at five years was similar in both groups (80% and 76% for group 1 and 2 respectively, P>0.58). Fuhrman grade was the only independent prognostic factor of cancer-specific survival (P=0.001).
Patients younger than 40 years were more likely to have a translocation RCC than their older counterparts for who clear cell RCC represented the main histological sub-type. Cancer-specific survival was similar between both groups. Only a systematic specific immunostaining for TFE3 or TFEB will allow to assess the exact incidence and prognosis of this entity.
40岁以下肾细胞癌（RCC）患者的临床和病理特征尚不明确。本研究的目的是通过与一组58至62岁的患者进行比较，分析这些特征。
对2000年1月至2009年7月因肾肿块接受手术治疗的一组年龄小于40岁的患者（第1组，n = 44）和一组年龄在58至62岁之间的患者（第2组；n = 106）进行回顾性研究。对临床、病理特征及癌症特异性生存率进行比较分析。采用Kaplan-Meier方法计算特异性生存率，并与对数秩检验进行比较。进行单因素和多因素分析以评估和量化年龄对癌症特异性生存率的影响。协变量包括性别、年龄组、肿瘤大小、pT分期、组织学亚型和Fuhrman分级。
两组的临床和病理特征相似（P>0.05），但组织学亚型除外（第1组透明细胞RCC占56%，第2组为82%）。在年龄小于40岁的患者组中，易位性RCC占所有RCC的23%。两组的五年癌症特异性生存率相似（第1组和第2组分别为80%和76%，P>0.58）。Fuhrman分级是癌症特异性生存的唯一独立预后因素（P = 0.001）。
40岁以下的患者比年龄较大的患者更易发生易位性RCC，年龄较大的患者中透明细胞RCC是主要的组织学亚型。两组的癌症特异性生存率相似。只有对TFE3或TFEB进行系统的特异性免疫染色，才能评估该实体的确切发病率和预后。
