Villanueva Peña A, Gutiérrez Baños J L, Martín García B, Hernández Rodríguez R, Portillo Martín J A, Correas Gómez M A, del Valle Schaan J I, Roca Edreira A, Vega Vega A, Gutíerrez García R
Servicio de Urología, Hospital Universitario Marqués de Valdecilla, Santander.
Actas Urol Esp. 1996 Jan;20(1):37-42.
This is a comparative study of the various subtypes of renal carcinoma (divided according to their microscopic features in classic, papillary, Bellini's, sarcomatoid, chromophobe, small cells) on the 286 renal carcinomas removed in the Valdecilla Hospital over the last 25 years. For each type of presentation, age, gender, location, intrarenal status, tumoral diameter, clinical signs and symptoms, presence of metastasis, Fuhrman's core grade, Robson stage and survival, have been analyzed. No cases of small cells or chromophobe tumours were seen. Of the total 286 renal tumours, 253 (88.64%) showed a classical pattern, 21 (7.34%) were papillary, 10 (3.49%) sarcomatoid, and 2 (0.69%) Bellini's carcinomas. In the analysis by mean age at presentation, distribution by sex, involvement site and intrarenal location, no statistically significant differences were found between the different tumoral subtypes. In our series, the sarcomatoid type presents a larger average tumoral diameter than both the papillary and the classical ones (p < 0.01, p < 0.001, respectively). The most frequent clinical manifestation in all tumoral types was haematuria. The sarcomatoid tumours showed a statistically significant trend to present with higher core grade (G4) and higher tumoral stage (E IV) than papillary and classical tumours. Overall survival at 3 years was 72% for the papillary type, 65% for the classical and 22% for the sarcomatoid subtype, the latter being significantly worse than the first two (a < 0.001).
这是一项针对肾癌不同亚型（根据其微观特征分为经典型、乳头状、贝氏管型、肉瘤样型、嫌色细胞型、小细胞型）的对比研究，研究对象为过去25年里在巴尔德西利亚医院切除的286例肾癌。对于每种表现类型，分析了年龄、性别、位置、肾内情况、肿瘤直径、临床体征和症状、转移情况、福尔曼核分级、罗布森分期及生存率。未发现小细胞型或嫌色细胞瘤病例。在总共286例肾肿瘤中，253例（88.64%）呈经典模式，21例（7.34%）为乳头状，10例（3.49%）为肉瘤样，2例（0.69%）为贝氏管癌。在按发病时平均年龄、性别分布、受累部位及肾内位置进行的分析中，不同肿瘤亚型之间未发现统计学上的显著差异。在我们的系列研究中，肉瘤样型的平均肿瘤直径比乳头状和经典型都大（分别为p < 0.01，p < 0.001）。所有肿瘤类型中最常见的临床表现是血尿。与乳头状和经典型肿瘤相比，肉瘤样肿瘤在核分级较高（G4）和肿瘤分期较高（E IV）方面呈现出统计学上的显著趋势。乳头状类型的3年总生存率为72%，经典型为65%，肉瘤样亚型为22%，后者明显低于前两者（a < 0.001）。
