Huang Z X, DU Y Q, Zhang X P, Liu S J, Xu T
Department of Urology, Peking University People's Hospital, Beijing 100044, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2018 Oct 18;50(5):811-815.
To analyze the clinical and pathological characteristics of renal cell carcinoma bone metastasis (RCC-BM) patients.
Data of RCC-BM patients from July 2003 to November 2017 were retrospectively reviewed. The patients' baseline characteristics (age, gender), tumor characteristics [specific sites of bone metastasis, time to bone metastasis (TTBM), imaging features of bone disease, coexistence of other metastasis], as well as pathological features (histological classification of primary and bone metastasis, immunohistochemical stain results) were collected. Descriptive analysis and difference analysis were used.
A total of 113 RCC-BM patients were enrolled with the gender ratio (male:female) of 4:1, mean age of 59.39 years, and all present of osteolysis bone lesions. The common sites of bone metastasis were vertebra (46.0%) and pelvis (38.9%). Other distant metastasis sites coexisted in 28.3%, while 48.18% RCC-BM patients presented with synchronous metastasis (TTBM=0). The median TTBM for metachronous metastasis was 48 months. The majority in this cohort were determined to have primary tumor of clear cell carcinoma. After immunohistochemical examination to 104 RCC-BM patients and sub-group analysis, tendencies of higher positive rates of vascular endothelial growth factor (VEGF) was also found in synchronous group (P=0.097) while tendencies of higher positive rates of carbonic anhydrase (CA)-IX was found in the same group (P=0.100). The patients with clear cell RCC-BM had a significantly higher positive expression of epithelial growth factor receptor (EGFR, P<0.05) than those with non-clear cell RCC-BM group.
More male and younger patients with metastatic lesions in axial skeleton were found in this cohort. Tendencies in the expression of CA-IX and VEGF in different TTBM sub-group and EGFR in different histology-derived subgroup indicate that they might be associated with risk and prognostic factors and support further target therapies of RCC-BM.
分析肾细胞癌骨转移（RCC - BM）患者的临床和病理特征。
回顾性分析2003年7月至2017年11月期间RCC - BM患者的数据。收集患者的基线特征（年龄、性别）、肿瘤特征[骨转移的具体部位、骨转移时间（TTBM）、骨病的影像学特征、其他转移的共存情况]以及病理特征（原发灶和骨转移灶的组织学分类、免疫组化染色结果）。采用描述性分析和差异分析。
共纳入113例RCC - BM患者，男女比例为4:1，平均年龄59.39岁，均存在溶骨性骨病变。骨转移的常见部位为椎体（46.0%）和骨盆（38.9%）。28.3%的患者存在其他远处转移部位，48.18%的RCC - BM患者出现同步转移（TTBM = 0）。异时性转移的中位TTBM为48个月。该队列中的大多数患者被确定为原发性透明细胞癌。对104例RCC - BM患者进行免疫组化检查并进行亚组分析后，同步转移组中血管内皮生长因子（VEGF）阳性率也有升高趋势（P = 0.097），同一组中碳酸酐酶（CA）-IX阳性率也有升高趋势（P = 0.100）。透明细胞RCC - BM患者的上皮生长因子受体（EGFR）阳性表达显著高于非透明细胞RCC - BM组（P < 0.05）。
该队列中发现更多男性及轴骨有转移灶的年轻患者。不同TTBM亚组中CA - IX和VEGF的表达趋势以及不同组织学来源亚组中EGFR的表达趋势表明，它们可能与RCC - BM的风险和预后因素相关，并支持RCC - BM的进一步靶向治疗。
