Department of Urology, State University of New York Upstate Medical University, Syracuse, New York.
Department of Urology, State University of New York Upstate Medical University, Syracuse, New York.
J Urol. 2016 Apr;195(4 Pt 1):847-51. doi: 10.1016/j.juro.2015.10.177. Epub 2015 Nov 10.
The renal cell cancer incidence is relatively low in younger patients, encompassing 3% to 7% of all renal cell cancers. While young patients may have renal tumors due to hereditary syndromes, in some of them sporadic renal cancers develop without any family history or known genetic mutations. Our recent observations from clinical practice have led us to hypothesize that there is a difference in histological distribution in younger patients compared to the older cohort.
We queried the SEER (Surveillance, Epidemiology and End Results) 18-registry database for all patients 20 years old or older who were surgically treated for renal cell carcinoma between 2001 and 2008. Patients with unknown race, grade, stage or histology and those with multiple tumors were excluded from study. Four cohorts were created by dividing patients by gender, including 1,202 females and 1,715 males younger than 40 years old, and 18,353 females and 30,891 males 40 years old or older. Chi-square analysis was used to compare histological distributions between the cohorts.
While clear cell carcinoma was still the most common renal cell cancer subtype across all genders and ages, chromophobe renal cell cancer was the most predominant type of nonclear renal cell cancer histology in young females, representing 62.3% of all nonclear cell renal cell cancers (p <0.0001). In all other groups papillary renal cell cancer remained the most common type of nonclear renal cell cancer.
It is possible that hormonal factors or specific pathway dysregulations predispose chromophobe renal cell cancer to develop in younger women. We hope that this work provides some new observations that could lead to further studies of gender and histology specific renal tumorigenesis.
在年轻患者中,肾细胞癌的发病率相对较低,占所有肾细胞癌的 3%至 7%。虽然年轻患者可能因遗传性综合征而出现肾肿瘤,但在其中一些患者中,散发性肾细胞癌在没有家族史或已知基因突变的情况下发展。我们从临床实践中的最新观察结果得出假设,即年轻患者与老年患者相比,组织学分布存在差异。
我们查询了 SEER(监测、流行病学和最终结果)18 号登记数据库,以获取所有 2001 年至 2008 年间接受手术治疗肾细胞癌的 20 岁或以上的患者。排除种族、等级、分期或组织学未知以及患有多个肿瘤的患者。通过按性别将患者分为四个队列,包括 1202 名 40 岁以下的女性和 1715 名 40 岁以下的男性,以及 18353 名 40 岁以上的女性和 30891 名 40 岁以上的男性。使用卡方分析比较队列之间的组织学分布。
虽然透明细胞癌仍然是所有性别和年龄的最常见肾细胞癌亚型,但在年轻女性中,嫌色细胞肾细胞癌是最主要的非透明肾细胞癌组织学类型,占所有非透明细胞肾细胞癌的 62.3%(p <0.0001)。在所有其他组中,乳头状肾细胞癌仍然是最常见的非透明肾细胞癌类型。
可能是激素因素或特定途径失调使嫌色细胞肾细胞癌易于在年轻女性中发展。我们希望这项工作提供一些新的观察结果,这可能导致对性别和组织学特异性肾肿瘤发生的进一步研究。