| 乳头状肾癌的临床病理特征及其预后因素 |
| |
| 引用本文： | 高明珠,王进有,张海梁,王宏恺,叶定伟,张世林,戴波,朱耀,秦晓健,王朝夫. 乳头状肾癌的临床病理特征及其预后因素[J]. 中国癌症杂志, 2014, 24(4): 299-303. DOI: 10.3969/j.issn.1007-3969.2014.04.010 |
| |
| 作者姓名： | 高明珠 王进有 张海梁 王宏恺 叶定伟 张世林 戴波 朱耀 秦晓健 王朝夫 |
| |
| 作者单位： | 1. 复旦大学附属肿瘤医院泌尿外科，复旦大学上海医学院肿瘤学系，上海 200032 ；2. 复旦大学附属肿瘤医院病理科，复旦大学上海医学院肿瘤学系，上海 200032 |
| |
| 摘 要： | 背景与目的：乳头状肾细胞癌相对少见，目前国内对此类肿瘤的研究较少。本研究总结乳头状肾细胞癌患者的临床病理特征，并对可能影响此类患者生存的预后因素进行探索分析。方法：回顾分析64例乳头状肾细胞癌患者的临床、病理及随访资料。研究终点为总生存期，生存分析数据采用Kaplan-Meier法进行计算，并用Log-rank法对生存率进行比较，进一步对有意义的因素行COX模型多因素回归分析。结果：乳头状肾细胞癌占同期肾癌的6.04%，中位年龄为55岁(22~78岁)，54.7%的患者为无症状性肾癌。Ⅰ型肿瘤22例(34.4%)，Ⅱ型肿瘤42例(65.6%)，组织学亚型与肿瘤的TNM分期、Fuhrman分级和手术方式显著相关。中位随访时间为46.0个月(19~133个月)，共14例(21.9%)患者死亡，其中Ⅰ型1例(4.5%)，Ⅱ型13例(31.0%，P=0.018)，总生存率分别为85.7%和55.8%。单因素分析显示，伴有临床症状、Ⅱ型乳头状肾细胞癌、Fuhrman Ⅲ~Ⅳ级、淋巴结受累、远处转移和肾周脂肪侵犯是此类患者预后的影响因素，多因素分析显示，仅远处转移是影响总生存期的独立因子，差异有统计学意义(HR=14.78，P=0.004)。结论：与国外数据相比，我国乳头状肾细胞癌占肾癌的比重低，Ⅱ型肿瘤相对较常见。确诊时发生转移是影响此类患者总生存期的重要因素。
|
| 关 键 词： | 肾肿瘤 乳头状肾细胞癌 预后 |
Clinicopathologic features and prognostic factors of papillary renal cell carcinoma |
| |
| GAO Ming-zhu,WANG Jin-you,ZHANG Hai-liang,WANG Hong-kai,YE Ding-wei,ZHANG Shi-ling,DAI Bo,ZHU Yao,QIN Xiao-jian,WANG Chao-fu. Clinicopathologic features and prognostic factors of papillary renal cell carcinoma[J]. China Oncology, 2014, 24(4): 299-303. DOI: 10.3969/j.issn.1007-3969.2014.04.010 |
| |
| Authors: | GAO Ming-zhu WANG Jin-you ZHANG Hai-liang WANG Hong-kai YE Ding-wei ZHANG Shi-ling DAI Bo ZHU Yao QIN Xiao-jian WANG Chao-fu |
| |
| Affiliation: | 1.Departments of Urology, Fudan University Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 2.Departments of Pathology, Fudan University Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China |
| |
| Abstract: | Background and purpose: Papillary renal cell carcinomas (PRCC) is relatively infrequent, and there are few related researches in China. This study aimed to summarize the clinical and pathological features of PRCC, and evaluate prognostic factors for patients treated with surgery. Methods: A total of 64 patients who underwent surgery for PRCC were retrospectively assessed. PRCC tissue slides from each patient were reviewed for type (Ⅰor Ⅱ), grade, TNM stage, coagulative tumor necrosis and microvascular invasion. We estimated overall survival using the Kaplan-Meier method. Multivariate analysis was done according to the Cox proportional hazards model of factors statistically significant on univariate analysis. Results: The incidence rate of ENE was 6.04% in RCC, the median age was 55 (range 22 to 78) years. The comparison of the 22 (534.4%) type Ⅰ PRCCs and 42 (65.6%) type Ⅱ PRCCs revealed that type Ⅱ tumors were associated with a greater stage and grade more often. The median follow-up was 46 months (range 19 to 133). Of the 64 patients, 14 died, (4.5%) with type Ⅰ and 13 (31.0%) with type Ⅱ tumors (P=0.018). The overall survival rate was 85.7% in type Ⅰ tumors and 55.8% in type Ⅱ tumors, respectively. Univariate analysis identified symptoms at presentation, tumor type, TNM stage and grade as prognostic factors. On multivariate analysis only metastatic RCC remained associated with decreased overall survival (HR:14.78, P=0.004). Conclusion: The percentage of PRCC is lower and type Ⅱ PRCC is relatively common compared with foreign data. Metastasis at diagnosis is an independent predictive parameter of overall survival in Chinese patients with PRCC. |
| |
| Keywords: | Renal tumor Papillary renal cell carcinoma Prognosis |
| 本文献已被 CNKI 等数据库收录！ |
| 点击此处可从《中国癌症杂志》浏览原始摘要信息 |
|
点击此处可从《中国癌症杂志》下载全文 |
|
