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[肾嫌色细胞癌患者的临床病理研究]

[Clinicopathological study on patients with chromophobe cell renal carcinoma].

作者信息

Onishi T, Ohishi Y, Iizuka N, Suzuki Y, Suzuki H, Hosobe T, Nakajo H, Aizawa S, Suzuki M

机构信息

Department of Urology, Jikei University School of Medicine.

出版信息

Nihon Hinyokika Gakkai Zasshi. 1996 Oct;87(10):1167-74. doi: 10.5980/jpnjurol1989.87.1167.

Abstract

BACKGROUND

Reports on the patients with chromophobe cell renal carcinoma were very few. Therefore, the clinical features of this disease are uncertain. Based upon this background, we have studied on the clinicopathological characteristics of chromophobe cell renal carcinoma.

PATIENTS AND METHODS

From 1957 to 1995, seven hundred and fifty-one patients with renal cell carcinoma (RCC) were treated at the Jikei University Hospitals. Of these patients, 36 (4.8%) with chromophobe cell renal carcinoma were diagnosed by histopathological examination. Of these 36 patients, the objective patients were 34 who could be followed-up along with long interval.

RESULTS

The age distribution was 28 to 83 years old (mean was 54.1 years). Regarding to the sex difference, there observed male in 22 patients and female in 12 patients (sex ratio was 1.8: 1). Furthermore, the affected side was even, but there observed the symptoms of urinary tract mainly of haematuria in 24 patients (76.5%). As to the laboratory examination, there observed the abnormality of the acute phase reactants in 20% of patients. The greater diameter of the tumour was distributed from 1.5 to 17 cm (mean: 6.9 cm), and no consistent tendency of tumour localization was observed. Regarding the preoperative angiography, there observed the hypovascular/ avascular pattern in 15 patients (44.1%). As to the stage and grade, there observed the low stage patients in 30 (88.2%) and low grade patients in 27 (79.4%). With respect to the prognosis, the 1, 3, 5, 10, 15 and 20 years survival rates for chromophobe cell renal carcinoma were 97.1%, 81.6%, 81.6%, 70.2%, 61.9% and 46.7% respectively. After comparing the survival rate of the same stage and grade patients between the objected patients and the common types of RCC, there observed a favourable prognosis in the patients with chromophobe cell renal carcinoma. Especially in patients with eosinophilic variant, no cancer related death was observed.

CONCLUSION

The clinicopathological characteristics of chromophobe cell renal carcinoma show the hypovascular/avascular in angiography, low rate of laboratory abnormality, low stage/ low grade and a favourable prognosis compared with the common types of RCC.

摘要

背景

关于嫌色细胞肾细胞癌患者的报道非常少。因此,这种疾病的临床特征尚不确定。基于此背景,我们对嫌色细胞肾细胞癌的临床病理特征进行了研究。

患者与方法

1957年至1995年期间,日本庆应义塾大学医院共治疗了751例肾细胞癌(RCC)患者。其中,经组织病理学检查确诊为嫌色细胞肾细胞癌的有36例(4.8%)。在这36例患者中,有34例客观患者可进行长期随访。

结果

年龄分布为28岁至83岁(平均54.1岁)。在性别差异方面,男性22例,女性12例(性别比为1.8:1)。此外,患侧分布均匀,但24例患者(76.5%)出现了以血尿为主的泌尿系统症状。在实验室检查方面,20%的患者出现急性期反应物异常。肿瘤最大直径为1.5厘米至17厘米(平均6.9厘米),未观察到一致的肿瘤定位倾向。关于术前血管造影,15例患者(44.1%)呈现低血供/无血供模式。在分期和分级方面,30例(88.2%)为低分期患者,27例(79.4%)为低分级患者。关于预后,嫌色细胞肾细胞癌的1年、3年、5年、10年、15年和20年生存率分别为97.1%、81.6%、81.6%、70.2%、61.9%和46.7%。在比较客观患者与常见类型RCC相同分期和分级患者的生存率后,发现嫌色细胞肾细胞癌患者预后良好。特别是嗜酸性变异型患者,未观察到与癌症相关的死亡。

结论

嫌色细胞肾细胞癌的临床病理特征表现为血管造影显示低血供/无血供、实验室异常率低、低分期/低分级,与常见类型的RCC相比预后良好。

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