Vega Vega 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, Villanueva Peña A, Gutiérrez García R
Servicio de Urología, Hospital Universitario Marqués de Valdecilla, Santander.
Actas Urol Esp. 1996 Jul-Aug;20(7):605-13.
A revision has been made of 286 renal adenocarcinoma treated in the Urology service at the Hospital marqués de Valdecilla, Santander, during the period from January 1970 through December 1994, dividing the study in two groups based on diagnosis being incidental or clinically suspected, and comparing the following parameters: 5-year intervals incidence, age, gender, intrarenal location, tumoral diameter, histology, nuclear grade, tumour stage and survival. The objective was to analyze the possible differences between renal cell neoplasias diagnosed based on clinical behaviour and those diagnosed incidentally over a 25 year period. Of the 286 renal adenocarcinomas, 217 (77.5%) were symptomatic at diagnosis, 63 (22.5% were found accidentally, while presentation in 6 cases is unknown. The percentage of incidental diagnosis increases gradually from 0% during the 1970-75 period to 44.2% from 1990 to 1994. No significant differences were found between incidental and clinical cases with regard to gender, age at presentation, affected side or intrarenal location of the tumours. The tumoral diameter of incidental cases was 6.74 +/- 3.31 cm, and 8.53 +/- 3.66 in the clinical ones, the difference being significant (p < 0.001). Nuclear grade is lower in incidental cases than in clinical ones, with a significant difference (p < 0.01). Asymptomatic tumours occur with higher proportion at low Robson stages, 60.3% stage I vs. 30.5% of symptomatic cases (p < 0.001). A comparison of survival shows the existence of significant differences (p < 0.001) between incidentalomas and clinical adenocarcinomas, the significance in this differences fading when both groups are compared based on the stage. Relative to suspected cases, incidental tumours present less size, lower nuclear grade, lower stage and better survival, all these differences being highly significant. No significant differences are seen in survival between incidentalomas and symptomatic ones when compared by stage at tumour presentation.
对1970年1月至1994年12月期间在桑坦德瓦尔迪西利亚侯爵医院泌尿外科接受治疗的286例肾腺癌病例进行了回顾性研究。根据诊断是偶然发现还是临床怀疑将研究分为两组，并比较以下参数：5年发病率、年龄、性别、肾内位置、肿瘤直径、组织学、核分级、肿瘤分期和生存率。目的是分析在25年期间基于临床行为诊断的肾细胞肿瘤与偶然发现的肾细胞肿瘤之间可能存在的差异。在286例肾腺癌中，217例（77.5%）在诊断时有症状，63例（22.5%）是偶然发现 的，6例的就诊情况不明。偶然诊断的比例从1970 - 1975年期间的0%逐渐增加到1990年至1994年期间的44.2%。在性别、就诊年龄、患侧或肿瘤的肾内位置方面，偶然发现的病例与临床病例之间未发现显著差异。偶然发现病例的肿瘤直径为6.74±3.31厘米，临床病例为8.53±3.66厘米，差异有统计学意义（p<0.001）。偶然发现病例的核分级低于临床病例，差异有统计学意义（p<0.01）。无症状肿瘤在低罗布森分期中所占比例较高，I期为60.3%，有症状病例为30.5%（p<0.001）。生存率比较显示，偶然发现的肿瘤与临床腺癌之间存在显著差异（p<0.001），当根据分期对两组进行比较时，这种差异的显著性减弱。相对于疑似病例，偶然发现的肿瘤体积较小、核分级较低、分期较低且生存率较高，所有这些差异都非常显著。根据肿瘤就诊时的分期进行比较时，偶然发现的肿瘤与有症状肿瘤在生存率方面未发现显著差异。
