肾脏偶发癌临床分析(附116例报告)

目的　探讨肾脏偶发癌的临床特征、预后因素及诊治措施。　方法　 1993年至 2 0 0 1年肾脏偶发癌 116例 ,男 81例 ,女 35例 ,平均发病年龄 (5 7.2± 15 .6 )岁 ;与同期收治症状癌 138例的发病、诊治及预后等临床资料进行对比分析。　结果　肾脏偶发癌占肾癌的 4 5 .7% (116 /2 5 4 ) ,近 5年占 4 7.5 % (84 /177)。健康体检发现者占偶发癌的 6 3.8% (74 /116 )。偶发癌性别、平均发病年龄、侧别、吸烟史与症状癌差异无显著性意义 (P >0 .0 5 )。偶发癌B超检出率 98.2 % (10 8/110 )。按Robson分期 ,偶发癌Ⅰ～Ⅱ期占 6 9.0 % ,高于症状癌的 4 9.3% ;Ⅲ～Ⅳ期占 31.0 % ,低于症状癌的 5 0 .7% ,两者差异有显著性意义 (P <0 .0 5 )。偶发癌手术切除率 92 .2 % (10 7/116 ) ,病理类型透明细胞癌占 84 .1% ,明显高于症状癌的 6 0 .9% (P <0 .0 5 )。偶发癌术后 3年、5年生存率分别为 86 .5 %和 81.3% ,明显高于症状癌的 70 .8%和 6 4 .2 % (P均 <0 .0 5 )。多因素分析显示预后主要与肿瘤分期相关 (RR =4 .95 ,P <0 .0 5 )。　结论　肾脏偶发癌占肾癌的比例较以前增加 ,适当条件下的健康体检有积极意义 ;肿瘤分期明显低于症状癌 ,3年和 5年生存率明显高于症状癌 ,其预后与肿瘤分期相关 ;根治性肾切除术是治疗     

58例偶发性肾癌的临床分析

目的探讨偶发性肾癌的临床特征、诊治方法和影响预后的因素。方法回顾性分析偶发性肾癌58例，非偶发性肾癌146例，对两组肿瘤的分期、分级与预后进行比较。结果偶发性肾癌的病理分期明显低于非偶发组（P〈0.01）；而肿瘤病理分级及组织类型无显著性差异（P〈0.05）；术后3年、5年、10年的生存率分别为92．4％、83．6％和72．4％，明显高于非偶发性肾癌组（P〈0.05）。结论B超、CT的广泛应用提高了偶发性肾癌的检出率；病理分期低、肿瘤小、早期发现和及早的根治性切除是偶发性肾癌预后好的主要原因。     

偶发肾癌的预后分析

目的探讨和分析偶发肾癌的临床特点、生存率。方法对346例肾癌的临床资料进行回顾性分析并进行生存情况的随访；分为2组，偶发肾癌153例，非偶发肾癌193例，按Robson分期统计各组的病例数，用SPSS11．5统计软件处理。结果偶发性肾癌与非偶发肾癌Robson分期的构成比不同，偶发癌分期较低（x^2=31．741，P〈0．01）。偶发癌3、5、10年生存率为84．20％、72．86％、67．15％，非偶发癌为67．78％、60．54％、47．37％，两组相比差异显著（x^2=8．53，P〈0．05），Kaplan-meier分析显示相同分期偶发癌与非偶发癌生存率差别无统计学意义，COX风险比例模型显示肾癌是否偶发不是影响愈后的因素（β=1．367，P=0．179），分期是影响愈后的独立因素（β=2．44，P〈0．01）。结论偶发肾癌多低分期，术后生存率较非偶发肾癌高，但同一分期内偶发肾癌与非偶发肾癌生存率差别无统计学的意义，偶发不是影响愈后的独立因素。     

青年乳腺癌71例的临床分析

目的　了解青年时期乳腺癌与中老年乳腺癌在临床上的差异。方法　回顾性分析 2 0年间 810例女性乳腺癌的病例。其中青年组 71例 (≤ 35岁 ) ;中老年 739例 (>35岁 )作为对照组。分析包括 :诊断过程、肿瘤分期、病理分型、治疗措施、5年生存率等。结果　两组比较 :发病至就诊的时间青年组 (5 6± 4)d较对照组 (35± 3)d长 ;u =2 .33;P <0 0 5 ;首诊失误率高于对照组 (5 6 3%vs2 8 6 % ;χ2 =2 3 38;P <0 0 5 ) ;侵袭性肿瘤的构成比高于对照组 (91 5 %vs 82 4% ;χ2 =3 84;P <0 0 5 ) ;完成计划辅助治疗的人数多于对照组 (70 7%vs 5 6 5 % ;χ2 =4 80 6 ;P <0 0 5 )。两组间 5年生存率的差异无显著意义 [5 5 6 % (2 0 / 36 )vs 6 2 5 % (192 / 30 7) ;χ2 =0 6 6 6 ;P <0 0 5 ]。结论　青年乳腺癌患者的临床特征与对照组间有较多的差异 ,但预后差异无显著意义     

胰腺良恶性疾病组织中Smad4mRNA,PTENmRNA,P73mRNA表达及意义

目的　研究胰腺癌、癌旁上皮和慢性胰腺炎组织中Smad4mRNA ,PTENmRNA ,P73mRNA表达特征及临床病理意义。方法　石蜡包块切片组织原位杂交染色法。结果　 2 0例慢性胰腺炎导管上皮和腺泡上皮Smad4mRNA ,PTENmRNA均为阳性表达 ,但P73mRNA均为阴性表达 ;2 5例胰癌旁上皮仅 1例重度不典型增生者呈Smad4mRNA ,PTENmRNA阴性表达和P73mRNA阳性表达 (均为同一病例 ) ;5 3例胰腺癌Smad4mRNA ,PTENmRNA ,P73mRNA阳性病例分别为 34例 (6 4 % )、31例 (5 8% )和 2 7例 (5 1% ) ;胰腺癌Smad4mRNA ,PTENmRNA阳性率明显低于慢性胰腺炎 (χ2 =9 6 ,P <0 0 0 5 ;χ2 =11 8,P <0 0 0 5 )和癌旁上皮 (χ2 =9 0 ,P <0 0 0 5 ;χ2 =11 4 ,P <0 0 0 5 ) ;而P73mRNA阳性率明显高于慢性胰腺炎 (χ2 =15 2 ,P <0 0 0 5 )和癌旁上皮 (χ2 =16 2 ,P <0 0 0 5 )。高分化腺癌和未转移病例Smad4mRNA ,PTENmRNA阳性率明显高于低分化腺癌 (χ2 =4 4 ,P <0 0 5 ;χ2 =4 7,P <0 0 5 )和转移癌 (χ2 =4 2 ,P <0 0 5 ;χ2 =3 9,P <0 0 5 ) ;而P73mRNA阳性率明显低于低分化腺癌 (χ2 =6 4 ,P <0 0 2 5 )和转移癌 (χ2 =4 7,P <0 0 5 )。Smad4mRNA与PTEmRNA在胰腺癌中表达呈正相关 (χ2 =5 6 ,P <0 0 2 5 ) ,P73mRNA与Sma     

肝胆管结石手术方式与疗效分析

目的　分析肝胆管结石手术治疗的方式与疗效的关系。方法　随访 16年间因肝胆管结石接受手术治疗的病人 4 18例 ,其中胆镜联合肝切除 36例并与同期其他术式比较其临床疗效。结果　 4 5 0例中获随访 4 18例 (92 9% ) ,手术至随访时间 6个月至 16年 5个月 (平均 6年 8个月 ) ,术中未用胆镜取石与使用胆镜取石组的残石率、胆管炎复发率、结石复发率、再手术率分别为 37 6 %和8 6 % (χ2 =4 1 4 ,P <0 0 1)、16 9%和 1 3% (χ2 =2 3 6 ,P <0 0 1)、10 2 %和 3 9% (χ2 =5 1,P <0 0 5 )、2 3 7%和 5 9% (χ2 =2 1 4 ,P <0 0 1) ;无切肝组与切肝组的残石率、胆管炎复发率、结石复发率、再手术率分别为 30 3%和 8 1% (χ2 =13 2 8,P <0 0 1)、12 9%和 1 6 % (χ2 =6 77,P <0 0 1)、9 0 %和 1 6 % (χ2 =4 5 5 ,P <0 0 5 )、2 0 2 %和 0 (χ2 =15 15 ,P <0 0 1)。结论　术中使用胆镜联合肝切除、胆肠吻合可明显提高肝胆管结石病人的疗效。     

前列腺癌分期方法的临床评价

目的 :探讨临床参数对前列腺癌分期的临床意义。　方法 :通过病理诊断、MRI检查及全身骨扫描对 112例经前列腺活检病理证实的前列腺癌进行分期 ,结合血清前列腺特异抗原 (PSA)、穿刺后Gleason评分、穿刺阳性针数百分率评价其临床意义。　结果 :112例前列腺癌中 ,血清PSA、Gleason评分、穿刺阳性针数百分率对前列腺癌分期有显著相关性 (r=0 .6 98,r=0 .6 74 ,r=0 .6 71,P均 <0 .0 0 1) ,但对B期和C期前列腺癌的诊断差异无显著性 (χ2=2 .6 75 ,P =0 .0 96 ;χ2 =0 .70 4 ,P =0 .4 0 1) ,血清PSA较Gleason评分和穿刺阳性针数百分率对D期的诊断差异有显著性 (χ2 =5 .135 ,P =0 .0 2 3;χ2 =4 .5 93,P =0 .0 32 )。血清PSA、Gleason评分和穿刺阳性针数百分率的敏感性分别为 76 .7%、83.3%和 77.8% ,特异性为 5 0 %、77.3%和 5 4 .5 % ,准确性为 71.4 %、82 .1%和 73.2 %。　结论 :血清PSA、Gleason评分、穿刺阳性针数百分率可预测前列腺癌的分期 ,穿刺后Gleason评分对前列腺癌分期的预测较血清PSA和穿刺阳性针数百分率更准确。血清PSA对远处转移性前列腺癌的预测更有意义     

细胞周期素E和表皮生长因子受体在乳腺癌中的表达及与预后的关系

目的探讨细胞周期素E(cyclinE)和表皮生长因子受体 (epidermalgrowthfactorreceptor,EGFR)在乳腺癌组织中的表达及其与转移复发和预后的关系。方法应用免疫组织化学方法检测110例乳腺癌组织中cyclinE蛋白和EGFR蛋白的表达水平。结果 110例乳腺癌中cyclinE和EGFR的阳性率均为 5 4 5 5 % ,这两种蛋白在乳腺癌组织中的表达呈正相关 (rs=0 82 3,P =0 0 0 1) ;乳腺癌组织中cyclinE和EGFR表达与肿瘤临床分期 (χ2 =12 86 ,P =0 0 0 5 ;χ2 =14 2 1,P =0 0 0 4 )、组织学分级 (χ2 =8 86 ,P =0 0 0 5 ;χ2 =4 90 ,P =0 0 4 )、淋巴结转移 (χ2 =10 2 2 ,P =0 0 0 1;χ2 =9 6 2 ,P =0 0 0 2 )、ER(χ2 =2 9 87,P =0 0 0 1;χ2 =32 0 8,P =0 0 0 1)、PR(χ2 =19 5 6 ,P =0 0 0 1;χ2 =2 6 92 ,P =0 0 0 1)均相关 ;cyclinE和EGFR阳性表达组的病例有局部复发和远处转移的发生率明显高于阴性表达组的病例 (χ2 =7 33,P =0 0 1;χ2 =7 88,P =0 0 0 5 ) ;cyclinE和EGFR阳性表达病例的平均生存时间和 5年生存率均明显低于阴性表达的病例。结论cyclinE和EGFR的表达可预测乳腺癌的转移和复发 ,是指导临床治疗及估计预后的有意义指标。     

肾癌组织蛋白激酶C亚型的表达及意义

目的　探讨蛋白激酶C(PKC)的 3种亚型cPKCα、cPKCβⅡ 和aPKCζ在肾癌组织中表达的临床意义。　方法　采用免疫组化SP法和原位杂交技术检测 38例肾癌组织中PKC 3种亚型的表达。　结果　肾癌组织cPKCα、cPKCβⅡ 和aPKCζ阳性表达率分别为 6 8.4%、34.2 %和 44 .7% ,其中T2～T4为 80 .9% ( 17 2 1)、42 .9% ( 9 2 1)和 5 7.1% ( 12 2 1)。T1 为 5 2 .9( 9 17)、2 3.5 % ( 4 17)和 2 9.4% ( 5 17) ,差异均有显著性意义 (P <0 .0 5 ) ;G2 ～G3 为 83.3% ( 2 0 2 4)、41.7% ( 10 2 4)和 5 4.1% ( 13 2 4) ,G1 为42 .9% ( 6 14)、2 1.4% ( 3 14)和 2 8.6 % ( 4 14) ,差异均有显著性意义 (P <0 .0 5 )。各种细胞类型的 3种PKC亚型相比差异无显著性意义 (P >0 .0 5 )。cPKCα阳性表达者 5年生存率为 45 .8% ( 11 2 4) ,明显低于cPKCα阴性者 81.8% ( 9 11) ,差异有显著性意义 (P <0 .0 1)。　结论　cPKCα、cPKCβⅡ 和aPKCζ阳性表达与肾癌的临床分期、细胞分级及预后有关 ,与细胞类型无关。可作为判断肾癌预后的指标之一。     

偶发肾癌和症状肾癌临床诊疗特点比较的Meta分析

目的 比较偶发肾癌和症状肾癌的临床诊疗特点,阐述早期检出肾癌的重要意义.方法 检索Medline、PubMed、Cochrane Library、Web of Science、万方数据库、CNKI中文期刊数据库2000年1月1日至2016年12月31日国内外公开发表的所有关于偶发肾癌和症状肾癌临床研究的文献,按照纳入和排除标准对文献进行筛选,对纳入研究的文献进行数据提取和质量评价,采用Review Manager 5.3软件进行Meta分析.结果 共纳入23篇文献,总计肾癌患者10 065例,其中偶发肾癌患者4 251例,症状肾癌患者5 814例.两组患者在肿瘤直径上平均差(MD)为-1.58(95% CI:-2.05~-1.11),在肿瘤病理分级(G1和G2)、保留肾单位手术例数、临床分期(T1和T2)、淋巴结转移、远处器官转移上比值比(OR)分别为3.01(95% CI:2.62~3.45)、3.47(95% CI:2.72~4.44)、3.95(95% CI:3.24~4.81)、0.20(95% CI:0.11~0.35)和0.24(95% CI:0.17~0.35),差异均有明显统计学意义(P<0.000 1);在手术年龄上MD为0.23(95% CI:-1.64~2.09),差异无统计学意义(P=0.81).结论 与症状肾癌相比,偶发肾癌具有肿瘤体积小、肿瘤病理分级低、临床分期早、淋巴结转移及远处器官转移少等特点,因此早期发现肾癌对提高患者生活质量及生存率十分重要.     

偶发肾癌的临床探讨(附96例报告)

目的提高偶发肾癌的诊治水平。方法对９６例偶发肾癌进行回顾性总结并与２０２例非偶发肾癌进行对比分析。结果与非偶发肾癌相比,偶发肾癌均为Ｉ～Ｉ期肿瘤,病理分期低（Ｐ＜００１）;平均肿瘤体积小（４４ｃｍ,Ｐ＜００１）;术后５年生存率（８９．８％）高于非偶发组（４５６％）（Ｐ＜００１）。结论偶发肾癌病理分期低,肿瘤体积小,术后远期生存率高;偶发肾癌概念的提出,对肾癌的早期诊治及良好的预后有重要意义。     

Clinical, histopathological and flow-cytometric properties of incidental renal cell carcinomas

Medical records of 63 patients operated on for renal cell carcinoma (RCC) between 1986 and 1996 in the Karlovac General Hospital were studied retrospectively. In 23 (36.5%) patients, the tumor was incidentally detected. The median patient age was 62 in the incidental group and 64 years in the symptomatic group (P > 0.05). Ultrasonography was the leading technique for incidental detection of RCC. The median tumor diameter was 6 cm in the incidental group and 9 cm in the symptomatic group (P < 0.001). Incidental carcinomas had a lower stage (P = 0.022) and a lower nuclear grade (P < 0.001) than the symptomatic ones. The incidental cases were associated with a more favorable ploidy status (P = 0.027) and a lower proliferative activity (P = 0.005). The 5-year survival rate was significantly higher in incidental (81.4%) than in symptomatic cases (44.3%) (P = 0.020). Univariate analysis showed that tumor stage, ploidy status, and proliferative activity were good prognostic parameters, while patient age, tumor size, and nuclear grade were not. Tumor stage was the only independent prognostic parameter in multivariate analysis. In conclusion, the incidentally detected RCC show more favorable clinical, histopathological, and flow-cytometric characteristics and their prognosis is significantly better than in symptomatic cases. Received: 21 July 1998 / Accepted: 1 July 1999     

青年型肾癌56例报告

目的探讨青年型肾癌的临床特征及诊治措施。方法青年型肾癌56例。男36例,女20例。平均发病年龄32.4岁。偶发癌20例,症状癌36例。病程2 d～4年。临床症状有肉眼血尿18例、腰腹胀痛23例、消瘦乏力2例、发热3例、可触及肿块2例,其中有2项以上症状者12例。单侧55例,双侧1例。56例患者均行B超、CT检查,11例患者行KUB加IVU检查,2例行MR检查。50例行根治性肾切除,6例行保留肾单位手术。术后随访7～108个月,平均64个月。结果B超诊断错构瘤4例,多囊肾1例,肾脏炎性肿块1例,肾肿瘤50例;B超检出率89.3%。CT诊断为错构瘤2例,肾肿瘤54例;CT检出率96.4%。行MR检查2例,诊断肾肿瘤1例,错构瘤1例。9例有症状者行KUB加IVU检查,5例示肾集合系统受压,1例未显影,1例示肾盏破坏,2例示肾外形增大;2例偶发癌者行KUB加IVU检查均未见明显异常。20例偶发癌者肿瘤直径1.8～10.0 cm,平均4.8 cm;其中T1N0M0者16例,T2N0M0者3例,T3N0M0者1例。36例有症状者肿瘤直径2.5～13.0 cm,平均8.7 cm;其中T1N0M0者20例,T2N0M0者7例,T3N0M0者4例,淋巴结阳性者5例。偶发癌组20例中仅1例(T3N0M0)行根治术者于术后19个月肾窝复发,再次手术治疗,于术后53个月死于全身转移;偶发癌组的5年存活率为92.3%。症状癌组中8例因癌死亡,4例失访,5年存活率为66.7%。2组5年存活率比较差异有统计学意义(P=0.042)。结论青年型肾癌恶性程度与普通人群肾癌相仿,根治性肾切除是主要的治疗方式,合适的患者可行保留肾单位手术。     

Renal cell carcinoma: incidental detection and pathological staging

In developed countries, there has been increased incidental detection of renal cell carcinoma (RCC). The incidence, pathological stage and survival of incidentally detected carcinoma in a developing country in Asia where, from 1990 to 1998, 165 renal cell carcinomas were identified. The clinical presentation, diagnostic-imaging modality employed, pathological staging and patient survival was reviewed. Incidental renal cancers included those that were diagnosed through health screening or detected incidentally through imaging studies for other conditions. The survival between these incidentally detected lesions and their symptomatic counterparts (suspected group) was compared. Sixty-four patients (39%) had their tumours detected incidentally, including 39 who were entirely asymptomatic and 25 who presented with non-specific symptoms, not initially suggestive of RCC. For the entire group, computed tomography provided the definitive diagnosis in 81% of cases. The incidental detection group had significantly smaller size of tumour (5.9 cm c.f. 7.6 cm), lower stage and lower histological grading. In particular, 78% of patients with incidental RCC had stage I or II diseases (TNM stage classification), compared with 57% of patients with suspected tumour (p < 0.05; Chi-square test). The disease free survival was significantly better for those with incidental detection (86% c.f. 66% at last follow up; p < 0.05; log-rank test) over a mean follow up period of 33 months (range 1-91). Regression analysis showed that stage of disease was the only independent variable predictive of clinical outcome. In conclusion, that significant numbers of RCC were detected incidentally. These tumours were of a lower clinical pathological stage and had a better prognosis.     

Incidentally diagnosed renal cell carcinoma.

We analyzed the incidence, sex and age distribution, diagnostic methods and survival rate of incidentally detected renal cell carcinomas (RCCs) and compared these factors with those of symptomatic RCCs. Of 141 patients with RCC treated between 1980 and 1989, 44 cases (31.4%) were incidentally detected. Thirty-one of these 44 cases were diagnosed by abdominal ultrasonography. The age of the incidental cases was significantly higher than that of the symptomatic ones (p = 0.045), particularly in male patients (p = 0.049). The tumor size in incidental cases was smaller and tumor stage earlier (p less than 0.0001). Moreover, the grade of malignancy was significantly lower, and clear cell type tumors were more frequently detected in the incidental cases. No difference was observed between the survival rates of incidental and symptomatic cases with stage 1 or 2 tumors. Of the incidental cases with stage 1 or 2, however, no patient with a tumor 3 cm or less in diameter has died. In conclusion, abdominal ultrasonography is a useful tool to detect RCC at an early stage, and patients with a relatively small tumor tend to have a good prognosis.     

Cyst-associated renal cell carcinoma: Clinicopathologic characteristics and evaluation of prognosis in 27 cases

BACKGROUND: No consistent clinicopathologic characteristics of cyst-associated renal cell carcinoma (CRCC) have previously been determined. METHODS: In total, 768 patients with renal cell carcinoma (RCC) underwent radical or partial nephrectomy. Renal cell carcinoma was classified as CRCC in 27 of these patients (3.5%, subdivided into RCC originating in a cyst and cystic RCC), clear-cell RCC in 662 patients (86.2%), chromophobe cell renal carcinoma in 36 patients (4.7%) and papillary RCC in 43 patients (5.6%) according to the criteria of the World Health Organization. RESULTS: The pathologic stage and nuclear grade were usually lower in those with CRCC (low stage/low grade; 89%/96%) or chromophobe cell renal carcinoma (low stage/low grade; 89%/80%) than in those with clear-cell RCC (low stage/low grade; 59%/65%) or papillary RCC (low stage/low grade; 53%/69%). Of the 27 CRCC patients, only 19 (70%) could be diagnosed through preoperative imaging studies. Patients with CRCC showed a favorable prognosis (survival rate: 95% at 1 year, 89.7% at 3 years and 84.4% thereafter) and, especially among the patients with RCC originating in a cyst, no cancer-related death was observed. Comparing the survival among four types of RCC, a favorable outcome was observed in cases of CRCC or chromophobe cell renal carcinoma compared with clear-cell RCC or papillary RCC (clear vs chromophobe: P = 0.002; chromophobe vs papillary: P = 0.019; clear vs cyst-associated: P = 0.001; papillary vs cyst-associated: P = 0.00079). CONCLUSIONS: In cases of CRCC, the disease was usually detected at lower stages and grades and therefore the prognosis was better than in cases of other types of RCC. Preoperative diagnosis of this disease was very difficult, especially in cases of RCC originating in a cyst.     

Clinical study of renal cell carcinoma as incidental finding

Reports on renal cell carcinoma (RCC) as an incidental finding have been increasing in recent years as the imaging modalities including ultrasonography (US) and computerized tomography (CT) scan have gained popularity in clinical medicine. Because effective treatment in RCC is only surgical removal of the involved kidney even at present, it is imperative for urologists to find and to diagnose the RCC in early stage. Whether RCC found incidentally is in early stage cancer is not determined at present. To determine if the RCC found incidentally is in early stage cancer and if the survival rate is better than that of the RCC found with symptoms, we undertook the following study. Between December 1972 and March 1990, 65 patients with RCC were registered at the Department of Urology, Teikyo University Hospital. Of 65 patients 20 with RCC as an incidental finding were subjected to this study. 34 patients with RCC found with symptoms including hematuria were subjected to control group. Causes of the diagnosis in 20 patients included workup for non-urological diseases in 11 patients (55.0%), workup for urological disease other than RCC in 5 patients (25.0%) and routine medical checkup in 4 patients (20.0%). First-line imaging modalities for the diagnosis was US in 9 patients (45.0%), DIP in 6 patients (30.0%) and CT in 5 patients (25.0%). Size of the tumor, pathological stage (pT) and grade in these 20 patients were tended to be smaller and lower, respectively, but these results were not significant as compared to those of the control group. Incidence of the remote metastasis, at the time of diagnosis, however, was significantly lesser than that of the control group (p = 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)     

Incidental detection beyond pathological factors as prognostic predictor of renal cell carcinoma

PURPOSE: To evaluate the prognostic significance of different detection modalities of renal cell carcinoma (RCC) in a large cohort of patients who had been previously submitted to surgery in two teaching hospitals in Italy. MATERIALS AND METHODS: We reviewed the clinical records of 1446 patients who had been submitted to surgical treatment for RCC at the Departments of Urology of Padua (n=747) and Verona (n=699) from 1976 to 2000. Patients were classified into two groups according to the detection mode: symptomatic and incidental. The cancer-specific survival probability was estimated according to the Kaplan-Meier method. In order to compare the survival curves the log rank test was used. The predictive independent value of the variables was examined using the Cox proportional hazards model. RESULTS: Six hundred and thirty patients (43.6%) were treated for incidental RCC and 816 (56.4%) for symptomatic RCC. In the incidental group, the size (p<0.001), the pathological stage (p<0.001) and the nuclear grading (p<0.001) of tumors were lower than those causing symptoms. The 5-year and 10-year cancer-specific survival probability were 84% and 75% in the incidental group, and 66% and 54.5% in the symptomatic group (p<0.0001), respectively. At a multivariate analysis, the mode of detection was an independent predictive variable (H.R. 1.559), as well as pathological stage (H.R. 1.809), nuclear grading (H.R. 1.411), size 相似文献   

肾细胞癌中Mina53的表达及其与临床病理及预后的关系

目的 探讨肾细胞癌组织中Mina53的表达水平及其与临床病理及预后的关系.方法 采用RT-PCR技术测定96例肾细胞癌组织及20例癌旁正常肾组织中Mina53的表达,免疫组化法测定其蛋白水平的表达,分析其结果与临床病理及预后的关系.结果 Mina53平均模板量在肾细胞癌组织中的表达明显高于正常肾组织的表达(P＜0.01),且在Ⅲ期、Ⅳ期肾细胞癌组织中的表达明显高于Ⅰ期、Ⅱ期的表达水平(P＜0.01),Mina53蛋白在肾细胞癌组织中的表达水平明显高于其在正常肾组织的表达水平(P＜0.01);Mina53高表达者的预后较低表达者明显要差(P＜0.01).结论 Mina53基因及蛋白的高表达与肾细胞癌临床病理分期有关,其表达水平越高,预后越差,Mina53有望成为预后判断的新指标.