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终末期肾病中的肾细胞癌:来自匈牙利患者的回顾性研究。

Renal Cell Carcinoma in End-Stage Renal Disease: A Retrospective Study in Patients from Hungary.

机构信息

Department of Pathology, Medical School and Clinical Centre, University of Pécs, Pécs, Hungary.

MedServ Ltd., Budapest, Hungary.

出版信息

Pathobiology. 2023;90(5):322-332. doi: 10.1159/000529276. Epub 2023 Jan 25.

Abstract

INTRODUCTION

End-stage renal disease (ESRD) and acquired cystic kidney disease (ACKD) are known risk factors for renal cell carcinoma (RCC). Hereby, the clinicopathological features of RCCs developed in ESRD were investigated.

METHODS

A database consisting of 34 tumors from 31 patients with ESRD among 2,566 nephrectomy samples of RCC was built. The demographic, clinical, and follow-up data along with pathological parameters were analyzed. The RCCs were diagnosed according to the current WHO Classification of Urinary and Male Genital Tumors.

RESULTS

Twenty-two tumors developed in men and 12 in women, with a median age of 56 years (range: 27-75 years). The causes of ESRD were glomerulonephritis (n = 7), hypertensive kidney disease (n = 6), autosomal dominant polycystic kidney disease (n = 6), chronic pyelonephritis (n = 4), diabetic nephropathy (n = 3), chemotherapy-induced nephropathy (n = 1), and undetermined (n = 4). ACKD complicated ESRD in 12 patients. The following histological subtypes were identified: clear cell RCC (n = 19), papillary RCC (n = 5), clear cell papillary tumor (n = 5), ACKD RCC (n = 3), and eosinophilic solid and cystic RCC (n = 2). The median tumor size was 31 mm (range: 10-80 mm), and 32 tumors were confined to the kidney (pT1-pT2). There was no tumor-specific death during the period of this study. Progression was registered in 1 patient.

CONCLUSION

In our cohort, the most common RCC subtype was clear cell RCC (55%), with a frequency that exceeded international data appreciably (14-25%). The incidence of clear cell papillary tumor and ACKD RCC (14.7% and 8.5%) was lower than data reported in the literature (30% and 40%). Our results indicate a favorable prognosis of RCC in ESRD.

摘要

介绍

终末期肾病(ESRD)和获得性囊性肾病(ACKD)是肾细胞癌(RCC)的已知危险因素。在此,研究了 ESRD 患者中发生的 RCC 的临床病理特征。

方法

建立了一个由 31 名 ESRD 患者的 34 个肿瘤组成的数据库,这些患者来自 2566 例 RCC 肾切除术样本。分析了人口统计学、临床和随访数据以及病理参数。根据当前的世界卫生组织(WHO)泌尿系统和男性生殖器肿瘤分类诊断 RCC。

结果

22 例肿瘤发生于男性,12 例发生于女性,中位年龄为 56 岁(范围:27-75 岁)。ESRD 的病因是肾小球肾炎(n=7)、高血压性肾病(n=6)、常染色体显性多囊肾病(n=6)、慢性肾盂肾炎(n=4)、糖尿病肾病(n=3)、化疗诱导的肾病(n=1)和未确定(n=4)。12 例患者的 ACKD 使 ESRD 复杂化。确定了以下组织学亚型:透明细胞 RCC(n=19)、乳头状 RCC(n=5)、透明细胞乳头状肿瘤(n=5)、ACKD RCC(n=3)和嗜酸性实性和囊性 RCC(n=2)。肿瘤的中位大小为 31 毫米(范围:10-80 毫米),32 个肿瘤局限于肾脏(pT1-pT2)。在本研究期间,没有与肿瘤相关的死亡。1 例患者发生进展。

结论

在我们的队列中,最常见的 RCC 亚型是透明细胞 RCC(55%),其频率明显高于国际数据(14-25%)。透明细胞乳头状肿瘤和 ACKD RCC 的发生率(14.7%和 8.5%)低于文献报道的(30%和 40%)。我们的结果表明 ESRD 中 RCC 的预后良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d4a/10614572/5ee42e8afe26/pat-2023-0090-0005-529276_F01.jpg

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