肾癌多中心病灶的危险因素

目的分析肾细胞癌多中心病灶与假包膜完整性、血管浸润的相关性。方法收集2007年3月到2011年8月,河源市人民医院泌尿外科肾癌根治术标本50例,间隔2mm分层切开,假包膜外15mm范围及肾门组织连续取材,检查假包膜完整性、肾门血管浸润、镜下多中心灶。结果多中心病灶的发生率在肾癌原发灶假包膜不完整组为26.4%(4/15),明显高于完整组的0.08%(3/35),P<0.05;多中心病灶的发生率在标本中血管浸润阳性组为50%(5/10),明显高于阴性组的5.0%(2/40),P<0.05。Logistic回归分析显示,包膜完整性及血管浸润是多中心灶的显著相关因素(P<0.05)。结论假包膜完整性及血管浸润是多中心病灶的高危因素。

The Risk Factors of Multicentricity in Renal Cell Carcinoma

Objective To analyze the correlation between multicentricity in renal cell carcinoma and completeness of pseudocapsule, vascular invasion. Methods Fifty specimens of radical nephrectomy in Heyuan People’s Hospital from 2007 to 2011 were selected. All specimens were sectioned at 3 mm intervals, then on each slice of the samples, parenchyma margin of 15 mm beyond pseudocapsule and tissues around renal sinus were continuously sectioned to examine the completeness of pseudocapsule, vascular invasion and micro-multifocal carcinoma. Results The incidence showed 0.08% in the tumors with complete pseudocapsule, while 26.4% in those interrupted pseudocapsule (P <0.05). The incidence in the tumors with positive vascular invasion was 50%, while 5% in negative (P <0.05). Logistic regression analysis showed that vascular invasion and completeness of pseudocapsule were two significant predictors of multicentricity (P <0.05). Conclusions Completeness of pseudocapsule and vascular invasion are the dangerous factors of multicentricity in renal cell carcinoma.