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中国嫌色性肾细胞癌患者临床和病理特征的预后价值:一项为期10年的单中心研究

Prognostic Value of Clinical and Pathological Features in Chinese Patients with Chromophobe Renal Cell Carcinoma: A 10-Year Single-Center Study.

作者信息

Xie Yongpeng, Ma Xin, Li Hongzhao, Gao Yu, Gu Liangyou, Chen Luyao, Zhang Xu

机构信息

Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing, China.

School of Medicine, Nankai University, Tianjin, China.

出版信息

J Cancer. 2017 Sep 27;8(17):3474-3479. doi: 10.7150/jca.19953. eCollection 2017.

Abstract

To evaluate the prognostic significance of clinicopathological features in a large series of Chinese patients with chromophobe renal cell carcinoma (RCC). Patients with chromophobe RCC who were treated surgically for renal masses at Chinese PLA General Hospital from 2006 to 2015 were identified. Tissue slides were reviewed to verify diagnoses and collect clinicopathological variables. Cox proportional hazard regression models and the Kaplan-Meier method were performed to evaluate the significance of clinicopathological variables on survival outcomes. A total of 209 patients with chromophobe RCC were enrolled in this study. There were only 13 cancer-specific events, which included 7 local recurrences and 6 metastases. The estimated 5-year and 10-year disease-free survival (DFS) rates were 92.4% and 83.1%, respectively. Univariate analysis indicated that tumor size, 2010 AJCC TNM stage, grade, sarcomatoid differentiation and urinary collecting system invasion were correlated with poor DFS. Multivariate analysis revealed that tumor size, 2010 AJCC TNM stage and grade were independent predictors of DFS. According to this long-term follow-up on a large number of Chinese patients, we found that chromophobe RCC was associated with a very low rate of cancer-specific events (6.2%) and has a better prognosis than clear cell RCC. Tumor size, 2010 AJCC TNM stage and grade were independent prognostic factors in Chinese patients with chromophobe RCC. The presence of these features in a nephrectomy specimen with chromophobe RCC warrants more active surveillance.

摘要

评估一系列中国嫌色性肾细胞癌(RCC)患者临床病理特征的预后意义。确定2006年至2015年在中国人民解放军总医院接受肾肿块手术治疗的嫌色性RCC患者。复查组织切片以核实诊断并收集临床病理变量。采用Cox比例风险回归模型和Kaplan-Meier方法评估临床病理变量对生存结果的意义。本研究共纳入209例嫌色性RCC患者。仅有13例癌症特异性事件,包括7例局部复发和6例转移。估计的5年和10年无病生存率(DFS)分别为92.4%和83.1%。单因素分析表明,肿瘤大小、2010年美国癌症联合委员会(AJCC)TNM分期、分级、肉瘤样分化和肾盂侵犯与DFS差相关。多因素分析显示,肿瘤大小、2010年AJCC TNM分期和分级是DFS的独立预测因素。根据对大量中国患者的长期随访,我们发现嫌色性RCC的癌症特异性事件发生率非常低(6.2%),且预后比透明细胞RCC好。肿瘤大小﹑2010年AJCC TNM分期和分级是中国嫌色性RCC患者的独立预后因素。在嫌色性RCC肾切除标本中出现这些特征需要更积极的监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3795/5687161/c17014d888f7/jcav08p3474g001.jpg

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