Oya M, Nakamura K, Baba S, Hata J, Tazaki H
Department of Urology, Keio University, School of Medicine, Tokyo, Japan.
Urology. 1995 Aug;46(2):161-4. doi: 10.1016/s0090-4295(99)80186-1.
This study was designed to gain more insight into the incidence of satellites of renal cell carcinoma related to the pathologic stage and grade of the primary tumor.
One hundred eight nephrectomized kidneys with renal cell carcinoma were sectioned at 3-mm intervals and inspected microscopically for satellite carcinomas. The number, site, size, and distance of satellite carcinomas found were recorded in relation to the primary carcinoma.
The overall incidence of satellite carcinoma was 6.5% (7 of 108). The incidence of satellite carcinoma in relation to the pathologic staging of the primary tumor was 7.1% (1 of 14) in pT1, 3.0% (2 of 66) in pT2, and 14.3% (4 of 28) in pT3. The incidence was higher in patients with N1 disease (25%) than in those with NO (5.0%), and higher in M1 disease (25%) than in those in MO (5.77%). There was no relationship between the grade and multicentricity.
The incidence of satellite carcinoma was higher in cases with high-stage primary carcinoma. However, even in localized diseases (PT1, pT2), satellite carcinomas were found at at 3.75% incidence. When nephron-sparing surgery is indicated in low-stage cases, precise clinical staging using a combination of various imaging modalities is mandatory, with intraoperative ultrasonography being one possible modality for detecting a concomitant satellite carcinoma.
本研究旨在更深入地了解肾细胞癌卫星灶的发生率与原发肿瘤病理分期及分级的关系。
对108例接受肾切除术的肾细胞癌肾脏标本每隔3毫米进行切片，并进行显微镜检查以寻找卫星癌。记录所发现卫星癌的数量、位置、大小以及与原发癌的距离。
卫星癌的总体发生率为6.5%（108例中有7例）。卫星癌的发生率与原发肿瘤的病理分期相关，在pT1期为7.1%（14例中有1例），pT2期为3.0%（66例中有2例），pT3期为14.3%（28例中有4例）。N1期患者的发生率（25%）高于N0期患者（5.0%），M1期患者的发生率（25%）高于M0期患者（5.77%）。分级与多中心性之间无相关性。
原发癌分期高的病例中卫星癌的发生率较高。然而，即使在局限性疾病（pT1、pT2）中，卫星癌的发生率也为3.75%。在低分期病例中进行保留肾单位手术时，必须使用多种成像方式进行精确的临床分期，术中超声检查是检测伴发卫星癌的一种可能方式。
