Wang Zhen, Liu Ning, Gan Weidong, Li Xiaogong, Zhang Gutian, Li Dongmei, Guo Hongqian
1 Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, CN.
2 Immunology and Reproductive Biology Laboratory & State Key Laboratory of Analytical Chemistry for Life Science, Medical School, Nanjing University, Nanjing, Jiangsu Province, CN.
J Int Med Res. 2017 Aug;45(4):1287-1296. doi: 10.1177/0300060517711358. Epub 2017 Jun 6.
Objective To analyze the postoperative recurrence of renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion (Xp11.2 tRCC). Methods This retrospective study was approved by the institutional review board and performed in accordance with the ethical standards established by the institution. Demographic, clinical, pathological, and follow-up data were compiled for the study cohort. Results During a mean follow-up of 41.3 months (range, 3-104 months), 8 of 34 patients with Xp11.2 tRCC were confirmed to have recurrence. Three of these patients died with poor outcomes due to a vena cava tumor embolus, and one died of distant metastasis 48 months after the initial nephrectomy during which lymph node metastasis was found. Three patients survived after cytoreduction surgery. One patient was diagnosed with lung metastasis 11 months postoperatively. Conclusions The TNM classification provides significant prognostic information for Xp11.2 tRCC. A relatively active surveillance algorithm is recommended, and cytoreduction surgery is an effective approach for recurrent Xp11.2 tRCC. Larger studies are required to more extensively investigate the recurrence of these potentially aggressive tumors.
目的 分析Xp11.2易位/TFE3基因融合相关性肾细胞癌（Xp11.2 tRCC）的术后复发情况。方法 本回顾性研究经机构审查委员会批准，并按照机构制定的伦理标准进行。收集研究队列的人口统计学、临床、病理及随访数据。结果 在平均41.3个月（范围3 - 104个月）的随访期间，34例Xp11.2 tRCC患者中有8例被证实复发。其中3例患者因腔静脉肿瘤栓子导致预后不良死亡，1例在初次肾切除术后48个月死于远处转移，当时发现有淋巴结转移。3例患者在减瘤手术后存活。1例患者术后11个月被诊断为肺转移。结论 TNM分类为Xp11.2 tRCC提供了重要的预后信息。建议采用相对积极的监测方案，减瘤手术是复发性Xp11.2 tRCC的有效治疗方法。需要开展更大规模的研究以更广泛地探究这些具有潜在侵袭性肿瘤的复发情况。
