Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido.
Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido.
Urol Oncol. 2019 May;37(5):301.e19-301.e25. doi: 10.1016/j.urolonc.2019.02.005. Epub 2019 Feb 27.
To evaluate the association between the RENAL nephrometry score (RNS) and tumor proliferative activity assessed by immunohistochemistry in patients with localized renal cell carcinoma.
The current study included 145 pathological T1 (pT1) clear cell renal cell carcinomas (ccRCC). Tumor proliferative activity was assessed with the Ki67 index and microvessel density (MVD). RNS was retrospectively assessed in the present study. We divided patients into 3 groups according to RNS (RNS 4-6: low-complexity, 7-9: moderate complexity, and 10-12: high-complexity tumors) and compared the Ki67 index as well as MVD among the 3 groups. The association between the Ki67index/MVD and each component (R, E, N, A, L, h) was also evaluated.
There were 56 low, 84 moderate, and 5 high-complexity tumors. The median Ki67 index of all tumors was 5.34% (interquartile range: 3.28-8.57). The median Ki67 index of low, moderate, and high-complexity tumors was 3.97%, 6.39%, and 11.27%, respectively, with a significant difference among the 3 groups (Kruskal-Wallis test, P = 0.0004). On the other hand, the median MVD of low, moderate, and high-complexity tumors was 14.11%, 14.42%, and 21.22%, respectively, and there were no significant differences among the 3 groups. In terms of each RNS component, there were significant differences in the Ki67 index among the 3 groups in N (P = 0.0101) and L (P = 0.0280) components, respectively.
The revealed association between RNS and the Ki67 index in pT1 clear cell renal cell carcinomas further supports the previous findings that the anatomy of renal cell carcinoma is associated with the malignant potential of localized clear cell renal cell carcinoma, which may provide additional information for treatment decision.
评估 RENAL 肾脏肿瘤评分（RNS）与局部肾细胞癌患者肿瘤增殖活性的免疫组织化学评估之间的相关性。
本研究纳入了 145 例病理 T1（pT1）透明细胞肾细胞癌（ccRCC）患者。通过 Ki67 指数和微血管密度（MVD）评估肿瘤增殖活性。本研究回顾性评估了 RNS。根据 RNS 将患者分为 3 组（RNS 4-6：低复杂度、7-9：中复杂度、10-12：高复杂度肿瘤），比较 3 组之间的 Ki67 指数和 MVD。还评估了 Ki67 指数/MVD 与各组成部分（R、E、N、A、L、h）之间的关系。
低复杂度肿瘤 56 例，中复杂度肿瘤 84 例，高复杂度肿瘤 5 例。所有肿瘤的中位 Ki67 指数为 5.34%（四分位间距：3.28-8.57）。低、中、高复杂度肿瘤的中位 Ki67 指数分别为 3.97%、6.39%和 11.27%，3 组间差异有统计学意义（Kruskal-Wallis 检验，P = 0.0004）。另一方面，低、中、高复杂度肿瘤的中位 MVD 分别为 14.11%、14.42%和 21.22%，3 组间差异无统计学意义。就每个 RNS 成分而言，N（P = 0.0101）和 L（P = 0.0280）成分的 Ki67 指数在 3 组间差异有统计学意义。
在 pT1 透明细胞肾细胞癌中，RNS 与 Ki67 指数之间的相关性进一步支持了先前的发现，即肾细胞癌的解剖结构与局部透明细胞肾细胞癌的恶性潜能相关，这可能为治疗决策提供额外的信息。
