Ding Z S, Qiu M, Xu Z C, Xiao R T, Ge L Y, Ma L L
Department of Urology, Peking University Third Hospital, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2018 Oct 18;50(5):805-810.
To investigate the clinicopathological features,treatment and prognosis of patients with papillary renal cell carcinoma (PRCC) and PRCC-complicated with tumor thrombus.
Single center retrospective analysis of 75 patients with PRCC treated from January 2012 to October 2017 was performed. There were 55 males and 20 females at an age range of 24-82 years. Sixteen PRCC patients were complicated with tumor thrombus. All the patients were with a surgery and had clear pathological diagnosis and detailed follow-up data. The clinicopathological features, prognosis and influencing factors of the patients with PRCC and PRCC complicated with tumor thrombus were analyzed and summarized.
The average age of the 75 patients was(56.05±11.59)years,the average body mass index (BMI) was (26±3) kg/m², and the average tumor maximum diameter was (5.17±3.85) cm. There were significant differences between tumor maximum diameter larger than 7 cm and less than 7 cm (69.6% vs. 94.4%, P<0.001), lymph node metastasis and no lymph node metastasis (<38% vs. 98%, P<0.001), adrenal metastasis and no adrenal metastasis (0% vs. 95.3%, P<0.001), pulmonary metastasis and no pulmonary metastasis (0% vs.90.7%, P<0.001), complicated with and without tumor thrombus (<66.4% vs. 93.5%, P<0.001) on the effect of 3-year survival rate of the PRCC patients. In this study, there were 16 patients with type 2 PRCC complicated with tumor thrombus. There were significant differences in concomitant symptoms (62.5% vs. 22.0%, P=0.005), maximum tumor diameter (68.8% vs.13.3%, P<0.001), adrenal metastasis (18.8% vs. 0.02%, P=0.029), pulmonary metastasis (18.8% vs. 0%, P=0.008), nuclear grade (P<0.001) and pathological type (100% vs. 44.1%, P<0.001) between the PRCC patients with and without tumor thrombus.
There were significant differences in tumor diameter,lymph node metastasis,adrenal metastasis, pulmonary metastasis,pathological type, nuclear grade and tumor thrombus in the effect of the 3-year survival rate of PRCC patients. PRCC patients with tumor thrombus were more commonly suffered from type 2 PRCC, for whom the tumor diameter was larger,the nuclear grade was higher,and the distance metastasis happened more easily.
探讨乳头状肾细胞癌(PRCC)及合并肿瘤血栓的PRCC患者的临床病理特征、治疗及预后。
对2012年1月至2017年10月收治的75例PRCC患者进行单中心回顾性分析。患者年龄24 - 82岁,男性55例,女性20例。16例PRCC患者合并肿瘤血栓。所有患者均接受手术治疗,病理诊断明确,随访资料详细。分析总结PRCC及合并肿瘤血栓的PRCC患者的临床病理特征、预后及影响因素。
75例患者平均年龄(56.05±11.59)岁,平均体重指数(BMI)为(26±3)kg/m²,肿瘤最大直径平均为(5.17±3.85)cm。肿瘤最大直径大于7 cm与小于7 cm、有淋巴结转移与无淋巴结转移、有肾上腺转移与无肾上腺转移、有肺转移与无肺转移、合并肿瘤血栓与未合并肿瘤血栓的PRCC患者3年生存率差异均有统计学意义(69.6% vs. 94.4%,P<0.001;<38% vs. 98%,P<0.001;0% vs. 95.3%,P<0.001;0% vs.90.7%,P<0.001;<66.4% vs. 93.5%,P<0.001)。本研究中,16例2型PRCC患者合并肿瘤血栓。合并与未合并肿瘤血栓的PRCC患者在伴随症状(62.5% vs. 22.0%,P = 0.005)、肿瘤最大直径(68.8% vs.13.3%,P<0.001)、肾上腺转移(18.8% vs. 0.02%,P = 0.029)、肺转移(18.8% vs. 0%,P = 0.008)、核分级(P<0.001)及病理类型(100% vs. 44.1%,P<0.001)方面差异均有统计学意义。
PRCC患者3年生存率在肿瘤直径、淋巴结转移、肾上腺转移、肺转移、病理类型、核分级及肿瘤血栓方面差异有统计学意义。合并肿瘤血栓的PRCC患者多为2型PRCC,其肿瘤直径较大,核分级较高,远处转移更容易发生。