CAJ | 학술논문

目的分析肾嫌色细胞癌的临床病理特征和预后特点,以提高肾嫌色细胞癌的诊治水平.方法回顾性分析68例肾嫌色细胞癌患者的临床和预后资料.采用Log rank检验分析患者临床病理特征与生存时间的关系,采用Kaplan-Meier法进行生存分析.结果 68例患者中50例行根治性肾切除术,18例行保留肾单位手术.肿瘤最大径1.5 ～16.0 cm,平均最大径5.7 cm.TNM分期为pT1aN0M0 25例,pT1bN0M0 22例,pT2aN0M0 9例,pT2bN0M0 5例,pT3aN0M0 7例.Fuhrman分级为Ⅰ级8例,Ⅱ级42例,Ⅲ级14例,Ⅳ级4例.集合系统受累3例,未受累65例.肾嫌色细胞癌患者3、5年生存率分别为93.0％和90.0％.Log rank检验结果显示,肿瘤最大径是否＞7 cm、TNM分期、集合系统受累与患者生存时间有关(均P ＜0.05).Cox多因素回归分析结果显示,肿瘤最大径是否＞7 cm是肾嫌色细胞癌患者生存时间的独立预测因素(P=0.038).结论肾嫌色细胞癌是一种临床少见、低度恶性的肾细胞癌,瘤体较大,预后较好；不适用Fuhrman分级系统；肿瘤最大径是否＞7 cm是肾嫌色细胞癌预后的独立预测因素.
목적 분석신혐색세포암적림상병리특정화예후특점,이제고신혐색세포암적진치수평.방법 회고성분석68례신혐색세포암환자적림상화예후자료.채용Log rank검험분석환자림상병리특정여생존시간적관계,채용Kaplan-Meier법진행생존분석.결과 68례환자중50례행근치성신절제술,18례행보류신단위수술.종류최대경1.5 ～16.0 cm,평균최대경5.7 cm.TNM분기위pT1aN0M0 25례,pT1bN0M0 22례,pT2aN0M0 9례,pT2bN0M0 5례,pT3aN0M0 7례.Fuhrman분급위Ⅰ급8례,Ⅱ급42례,Ⅲ급14례,Ⅳ급4례.집합계통수루3례,미수루65례.신혐색세포암환자3、5년생존솔분별위93.0％화90.0％.Log rank검험결과현시,종류최대경시부＞7 cm、TNM분기、집합계통수루여환자생존시간유관(균P ＜0.05).Cox다인소회귀분석결과현시,종류최대경시부＞7 cm시신혐색세포암환자생존시간적독립예측인소(P=0.038).결론 신혐색세포암시일충림상소견、저도악성적신세포암,류체교대,예후교호；불괄용Fuhrman분급계통；종류최대경시부＞7 cm시신혐색세포암예후적독립예측인소.
Objective To investigate the clinicopathological features and prognosis of chromophobe renal cell carcinoma (ChRCC).Methods The clinical data of 68 ChRCC cases treated in our department between January 2003 and September 2010 were collected and retrospectively analyzed.The prognostic factors were evaluated by Log-rank test.Kaplan-Meier survival curve was used to estimate the survival rate.Results Fifty cases were treated with radical nephrectomy and 18 with partial nephrectomy.The mean tumor size was 5.7 cm( 1.5-16.0 cm).The TNM stages were as follows:pTlaN0M0 in 25,pTlbN0M0 in 22,pT2aN0M0 in 9,pT2bN0M0 in 5,and pT3aN0M0 in 7.According to the Fuhrman grading system,8 patients were classified as grade Ⅰ,42 cases were grade Ⅱ,14 cases were grade Ⅲ,and 4 cases were grade Ⅳ.The 3-year and 5-year survival rates were 93.0％ and 90.0％,respectively.The log-rank test showed that tumor size ( ＞7 cm vs.≤7 cm) (P=0.004),TNM stage (T1-2 vs.T3-4) (P=0.008) and urinary collecting system invasion ( P =0.024 ) were associated with survival time.The multivariable Cox regression model revealed that tumor size ( ＞7 cm vs.≤7 cm) was an independent predictor of aggressive ChRCC (P =0.038).Conclusions ChRCC is a distinct type of renal cell carcinoma exhibiting a low degree of malignancy.Most tumors are larger,but predominantly with a favorable prognosis. Fuhrman nuclear grading is not suitable for ChRCC.Tumor size ( ＞7 cm vs.≤7 cm) is an independent predictor of prognosis of ChRCC.