Goldstein N S
Department of Anatomic Pathology, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.
Cancer. 1997 Sep 1;80(5):977-80.
The grading of renal cell carcinoma (RCC) has a long history. Currently, there are several grading systems in use throughout the world. There is no consensus regarding which grading system is optimal.
A review of the patient outcome cutpoints of several RCC grading systems was conducted to determine the advantages and disadvantages of the different systems.
Almost all authors who have conducted studies of RCC grading agree that it is useful in determining prognosis. The patient outcome cutpoints vary among studies, depending on which grading system is used. Different patient outcome cutpoints have been obtained with the same grading system but different patient groups.
The ideal RCC grading system has yet to be developed. Any new grading system should be predicated on a study that has separated RCC into the new genetically based subtypes. A new system should also be based on patient outcome, be large enough to account for other prognostic parameters, and be based on reproducible histologic criteria that are easy to apply.
肾细胞癌（RCC）的分级有着悠久的历史。目前，世界各地使用着几种分级系统。对于哪种分级系统最为理想，尚无共识。
对几种RCC分级系统的患者预后切点进行了综述，以确定不同系统的优缺点。
几乎所有进行过RCC分级研究的作者都认为，分级对于确定预后很有用。研究中的患者预后切点各不相同，这取决于所使用的分级系统。使用相同的分级系统但不同的患者群体，也会得到不同的患者预后切点。
理想的RCC分级系统尚未开发出来。任何新的分级系统都应以一项将RCC分为基于新基因的亚型的研究为基础。新系统还应基于患者预后，规模要足够大以纳入其他预后参数，并且应基于易于应用的可重复组织学标准。
