肾细胞癌中Fuhrman分级系统的重新分类——有影响吗？
Reclassification of the Fuhrman grading system in renal cell carcinoma-does it make a difference?
作者信息
Qayyum Tahir, McArdle Peter, Orange Clare, Seywright Morag, Horgan Paul, Oades Grenville, Aitchison Michael, Edwards Joanne
机构信息
Unit of Experimental Therapeutics, Institute of Cancer, College of MVLS, University of Glasgow, Western Infirmary, Glasgow, G11 6NT Scotland, UK.
出版信息
Springerplus. 2013 Aug 10;2:378. doi: 10.1186/2193-1801-2-378. eCollection 2013.
PURPOSE
The aim of this study was to determine whether reclassifying the Fuhrman grading system provides further prognostic information.
MATERIALS AND METHODS
We studied the pathological features and cancer specific survival of 237 patients with clear cell cancer undergoing surgery between 1997-2007 in a single centre. The original Fuhrman grading system was investigated as well as various simplified models utilising the original Fuhrman grade.
RESULTS
The median follow up was 69 months. On univariate analysis, the conventional Fuhrman grading system as well various simplified models were predicative of cancer specific survival. On multivariate analysis, only the three tiered modified model in which grades 1 and 2 were combined whilst grades 3 and 4 were kept separate was an independent predictor of cancer specific survival (p=0.001, HR 2.17, 95% CI 1.37-3.43). Furthermore this simplified model demonstrated a stronger relationship to recurrence than the conventional 4 tiered Fuhrman grading system.
CONCLUSIONS
A modified, three-tiered Fuhrman grading system has been demonstrated to be an independent predictor of cancer specific survival.
目的
本研究旨在确定重新分类福尔曼分级系统是否能提供更多预后信息。
材料与方法
我们研究了1997年至2007年间在单一中心接受手术的237例透明细胞癌患者的病理特征和癌症特异性生存率。研究了原始的福尔曼分级系统以及利用原始福尔曼分级的各种简化模型。
结果
中位随访时间为69个月。单因素分析显示，传统的福尔曼分级系统以及各种简化模型均可预测癌症特异性生存率。多因素分析显示，只有将1级和2级合并而3级和4级保持分开的三层改良模型是癌症特异性生存率的独立预测因素（p=0.001，HR 2.17，95%CI 1.37-3.43）。此外，该简化模型与复发的关系比传统的四级福尔曼分级系统更强。
结论
改良的三层福尔曼分级系统已被证明是癌症特异性生存率的独立预测因素。
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