Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
Urologische Praxis Straubing, Stadtgraben 1, 94315, Straubing, Germany.
World J Urol. 2021 Mar;39(3):829-837. doi: 10.1007/s00345-020-03226-8. Epub 2020 May 2.
DNA ploidy measurement has earlier been suggested as a potentially powerful prognostic tool in many cancer types, but the role in renal tumors is still unclear.
To clarify its prognostic impact, we analyzed the DNA content of 1320 kidney tumors, including clear cell, papillary and chromophobe renal cell carcinoma (RCC) as well as renal oncocytoma and compared these data with clinico-pathological parameters and patient prognosis.
A non-diploid DNA content was seen in 37% of 1276 analyzable renal tumors with a striking predominance in chromophobe carcinoma (74.3% of 70 cases). In clear cell carcinoma, a non-diploid DNA content was significantly linked to high-grade (ISUP, Fuhrman, Thoenes; p < 0.0001 each), advanced tumor stage (p = 0.0011), distant metastasis (p < 0.0001), shortened overall survival (p = 0.0010), and earlier recurrence (p < 0.0001). In papillary carcinoma, an aberrant DNA content was significantly linked to high Fuhrman grade (p = 0.0063), distant metastasis (p = 0.0138), shortened overall survival (p = 0.0010), and earlier recurrence (p = 0.0003).
In summary, the results of our study identify a non-diploid DNA content as a predictor of an unfavorable prognosis in clear cell and papillary carcinoma.
DNA 倍体测量早期被认为是许多癌症类型中一种潜在强大的预后工具，但在肾肿瘤中的作用仍不清楚。
为了阐明其预后影响，我们分析了 1320 例肾肿瘤的 DNA 含量，包括透明细胞癌、乳头状癌和嫌色细胞癌（RCC）以及肾嗜酸细胞瘤，并将这些数据与临床病理参数和患者预后进行了比较。
在可分析的 1276 例肾肿瘤中有 37%的肿瘤具有非二倍体 DNA 含量，在嫌色细胞癌中存在显著的优势（74.3%的 70 例）。在透明细胞癌中，非二倍体 DNA 含量与高级别（ISUP、Fuhrman、Thoenes；p<0.0001 各）、晚期肿瘤分期（p=0.0011）、远处转移（p<0.0001）、总生存期缩短（p=0.0010）和早期复发（p<0.0001）显著相关。在乳头状癌中，异常的 DNA 含量与高级别 Fuhrman（p=0.0063）、远处转移（p=0.0138）、总生存期缩短（p=0.0010）和早期复发（p=0.0003）显著相关。
综上所述，本研究结果表明，非二倍体 DNA 含量可预测透明细胞癌和乳头状癌的不良预后。
