Department of Pathology, Medical School and Clinical Centre, University of Pécs, Pécs, Hungary.
MedServ Ltd., Budapest, Hungary.
Pathobiology. 2023;90(5):322-332. doi: 10.1159/000529276. Epub 2023 Jan 25.
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.
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.
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.
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.
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。
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。
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。
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。