Tomera K M, Farrow G M, Lieber M M
J Urol. 1983 May;129(5):933-7. doi: 10.1016/s0022-5347(17)52464-7.
We reviewed the experience at this clinic from 1950 to 1980 with cases of grade 1 clear cell renal carcinoma. We wanted to determine whether patients with well differentiated clear cell renal tumors had the favorable clinical course that has been demonstrated for those with well differentiated oncocytic renal tumors. Of the 46 patients identified with pure grade 1 clear cell renal carcinoma two-thirds were discovered incidentally during diagnostic tests for unrelated complaints. These tumors generally were small, with 67 per cent being 6 cm. in diameter or smaller. Of all tumors 83 per cent were pathologic stage 1 (confined within the renal capsule). However, 10 patients have died of metastatic renal carcinoma and 3 are alive with disease. Actuarial survival curves show a significantly poorer prognosis for patients with grade 1 clear cell renal tumors compared to patients with grade 1 oncocytic renal tumors or to an age and sex-matched control group. We conclude that whereas well differentiated oncocytic renal tumors behave like benign renal tumors, well differentiated clear cell renal tumors can behave like aggressively malignant renal carcinomas and should be treated as such.
我们回顾了该诊所1950年至1980年期间1级透明细胞肾细胞癌病例的情况。我们想确定高分化透明细胞肾肿瘤患者是否具有已被证实的高分化嗜酸性肾肿瘤患者那样良好的临床病程。在确诊为单纯1级透明细胞肾细胞癌的46例患者中，三分之二是在因无关主诉进行诊断检查时偶然发现的。这些肿瘤通常较小，67%的肿瘤直径为6厘米或更小。所有肿瘤中83%为病理1期（局限于肾包膜内）。然而，有10例患者死于转移性肾癌，3例患者仍患有疾病。精算生存曲线显示，与1级嗜酸性肾肿瘤患者或年龄和性别匹配的对照组相比，1级透明细胞肾肿瘤患者的预后明显较差。我们得出结论，虽然高分化嗜酸性肾肿瘤的行为类似于良性肾肿瘤，但高分化透明细胞肾肿瘤的行为可能类似于侵袭性恶性肾细胞癌，应按此进行治疗。
