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肿瘤大小是肾细胞癌组织病理学特征的可靠预测指标吗?

Is tumor size a reliable predictor of histopathological characteristics of renal cell carcinoma?

作者信息

Turun Song, Banghua Liao, Zheng Shuo, Wei Qiang

机构信息

Department of Urology, West China Hospital, Sichuan University, Guoxue Xiang, Chengdu, Sichuan, China.

出版信息

Urol Ann. 2012 Jan;4(1):24-8. doi: 10.4103/0974-7796.91617.

Abstract

OBJECTIVES

To determine whether smaller tumor size is associated with less-aggressiveness in renal cell carcinoma (RCC).

MATERIALS AND METHODS

Series records of 505 patients diagnosed with RCC were retrospectively reviewed and the data concerning tumor size and pathological information were extracted and analyzed.

RESULTS

Five hundred and eight RCCs were identified. The mean tumor size was 5.02 ± 2.70 cm. No correlation was detected between the size of tumor and the histological subtype. The overall nuclear grade distribution was 57.1% and 42.9% for low-grade and high-grade disease, respectively. Each 1 cm increase in tumor size was associated with a significant increase in the odds ratio of high-grade disease by 1.46. 91.1% were found low-stage lesions and the odds ratio for the association of high-stage disease with each 1 cm increase in tumor size was 1.67. Multinomial models revealed that each 1 cm increase in the tumor size was associated with a 35% increase in renal capsule involvement and 66% renal vascular invasion. The cut-off point of tumor size in renal vascular invasion was 5.6 cm.

CONCLUSION

Tumor size is not an independent predictor for the histological subtype of RCC. However, it is closely correlated to histopathological features, with the indications that the greater the tumor size, the more aggressive potential the RCC is.

摘要

目的

确定较小的肿瘤大小是否与肾细胞癌(RCC)的侵袭性较低相关。

材料与方法

回顾性分析505例经诊断为RCC患者的系列记录,提取并分析有关肿瘤大小和病理信息的数据。

结果

共识别出508个RCC。肿瘤平均大小为5.02±2.70 cm。未检测到肿瘤大小与组织学亚型之间存在相关性。低级别和高级别疾病的总体核分级分布分别为57.1%和42.9%。肿瘤大小每增加1 cm,高级别疾病的优势比显著增加1.46。发现91.1%为低分期病变,肿瘤大小每增加1 cm,高分期疾病的优势比为1.67。多项模型显示,肿瘤大小每增加1 cm,肾包膜受累增加35%,肾血管侵犯增加66%。肾血管侵犯的肿瘤大小截断点为5.6 cm。

结论

肿瘤大小不是RCC组织学亚型的独立预测指标。然而,它与组织病理学特征密切相关,表明肿瘤越大,RCC的侵袭潜能越大。

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