中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2014年
4期
254-257
,共4页
王功伟%王颖%陈云新%胡浩%沈丹华
王功偉%王穎%陳雲新%鬍浩%瀋丹華
왕공위%왕영%진운신%호호%침단화
癌,肾细胞%病理学,临床%预后%存活率分析
癌,腎細胞%病理學,臨床%預後%存活率分析
암,신세포%병이학,림상%예후%존활솔분석
Carcinoma,renal cell%Pathology,clinical%Prognosis%Survival analysis
目的 研究肾细胞癌的基本临床及病理学特征. 方法 对1956年12月至2012年8月收治的705例肾细胞癌患者进行临床及病理学分析,并回顾相关文献. 结果 肾细胞癌直径0.6~18.0 cm,平均4.6 cm.透明细胞肾细胞癌、乳头状肾细胞癌、多房性透明细胞肾细胞癌、嫌色肾细胞癌以及未分类肾细胞癌分别占88.9% (627/705)、4.1%(29/705)、3.3%(23/705)、1.3% (9/705)和2.4%(17/705).Fuhrman核分级1、2、3、4级分别占19.0%(116/612)、58.3% (357/612)、18.1%(111/612)以及4.6%(28/612).肾盂、肾周脂肪及血管侵犯者分别占10.9% (66/603)、10.6%(64/603)和4.8%(29/603).TNM分期中T1期464例(76.6%),T2期65例(10.7%),T3期73例(12.0%),T4期4例(0.7%).淋巴结和远处转移率分别为2.8%(17/606)和3.5%(21/606).Ⅰ、Ⅱ、Ⅲ、Ⅳ期肿瘤分别占74.3% (450/606)、9.9%(60/606)、11.7%(71/606)以及4.1%(25/606).3、5、10、15年肿瘤特异性生存率分别为92.8%、86.9%、76.8%和55.5%,透明细胞肾细胞癌分别为92.8%、88.1%、77.4%和55.4%.多因素分析结果显示分期是肾细胞癌唯一的独立预后因素(P=0.000).结论 肿瘤分期是肾细胞癌独立的预后因素.在肾细胞癌的诊断中应该注意肾窦侵犯和淋巴结的评价.
目的 研究腎細胞癌的基本臨床及病理學特徵. 方法 對1956年12月至2012年8月收治的705例腎細胞癌患者進行臨床及病理學分析,併迴顧相關文獻. 結果 腎細胞癌直徑0.6~18.0 cm,平均4.6 cm.透明細胞腎細胞癌、乳頭狀腎細胞癌、多房性透明細胞腎細胞癌、嫌色腎細胞癌以及未分類腎細胞癌分彆佔88.9% (627/705)、4.1%(29/705)、3.3%(23/705)、1.3% (9/705)和2.4%(17/705).Fuhrman覈分級1、2、3、4級分彆佔19.0%(116/612)、58.3% (357/612)、18.1%(111/612)以及4.6%(28/612).腎盂、腎週脂肪及血管侵犯者分彆佔10.9% (66/603)、10.6%(64/603)和4.8%(29/603).TNM分期中T1期464例(76.6%),T2期65例(10.7%),T3期73例(12.0%),T4期4例(0.7%).淋巴結和遠處轉移率分彆為2.8%(17/606)和3.5%(21/606).Ⅰ、Ⅱ、Ⅲ、Ⅳ期腫瘤分彆佔74.3% (450/606)、9.9%(60/606)、11.7%(71/606)以及4.1%(25/606).3、5、10、15年腫瘤特異性生存率分彆為92.8%、86.9%、76.8%和55.5%,透明細胞腎細胞癌分彆為92.8%、88.1%、77.4%和55.4%.多因素分析結果顯示分期是腎細胞癌唯一的獨立預後因素(P=0.000).結論 腫瘤分期是腎細胞癌獨立的預後因素.在腎細胞癌的診斷中應該註意腎竇侵犯和淋巴結的評價.
목적 연구신세포암적기본림상급병이학특정. 방법 대1956년12월지2012년8월수치적705례신세포암환자진행림상급병이학분석,병회고상관문헌. 결과 신세포암직경0.6~18.0 cm,평균4.6 cm.투명세포신세포암、유두상신세포암、다방성투명세포신세포암、혐색신세포암이급미분류신세포암분별점88.9% (627/705)、4.1%(29/705)、3.3%(23/705)、1.3% (9/705)화2.4%(17/705).Fuhrman핵분급1、2、3、4급분별점19.0%(116/612)、58.3% (357/612)、18.1%(111/612)이급4.6%(28/612).신우、신주지방급혈관침범자분별점10.9% (66/603)、10.6%(64/603)화4.8%(29/603).TNM분기중T1기464례(76.6%),T2기65례(10.7%),T3기73례(12.0%),T4기4례(0.7%).림파결화원처전이솔분별위2.8%(17/606)화3.5%(21/606).Ⅰ、Ⅱ、Ⅲ、Ⅳ기종류분별점74.3% (450/606)、9.9%(60/606)、11.7%(71/606)이급4.1%(25/606).3、5、10、15년종류특이성생존솔분별위92.8%、86.9%、76.8%화55.5%,투명세포신세포암분별위92.8%、88.1%、77.4%화55.4%.다인소분석결과현시분기시신세포암유일적독립예후인소(P=0.000).결론 종류분기시신세포암독립적예후인소.재신세포암적진단중응해주의신두침범화림파결적평개.
Objective To investigate the clinicopathological features of renal cell carcinoma (RCC).Methods From December 1956 to August 2012,the clinicopathological features of RCC were studied in 705 cases and related literatures were reviewed.Results The diameter of RCC ranged from 0.6 to 18.0 cm,which the average size was 4.6 cm.The proportions of the clear cell,papillary,multilocular clear cell,chromophobe and unclassified histologic subtype were 88.9% (627/705),4.1% (29/705),3.3% (23/705),1.3% (9/705) and 2.4% (17/705),respectively.According to the Fuhrman grading system,the proportions of grade 1,2,3,4 were 19.0% (116/612),58.3% (357/612),18.1% (111/612)and 4.6% (28/612),respectively.The rates of invasion into the renal pelvis,perirenal fat and vascular were 10.9% (66/603),10.6% (64/603) and 4.8% (29/603),respectively.Of 705 cases,464 (76.6%)cases were in T1,65 (10.7%) cases in T2,73 (12.0%) cases in T3,and 4 (0.7%) cases in T4.As to the lymph node and distant metastasis,the rate was 2.8% (17/606) and 3.5% (21/606).The percentages of stage Ⅰ,Ⅱ,Ⅲ and Ⅳ RCC were 74.3% (450/606),9.9% (60/606),11.7% (71/606) and 4.1%(25/606),respectively.The 3-,5-,10-and 15-year disease-specific survival rate for RCC was 92.8%,86.9%,76.8% and 55.5%,respectively.To those patients with clear cell RCC,the disease-specific survival at the same time point was 92.8%,88.1%,77.4% and 55.4%,respectively.Multivariate analysis showed that the stage was the only independent prognostic factor for RCC.Conclusions Tumor stage of RCC is the independent prognostic factor for disease-specific survival.The evaluation of renal sinus invasion and lymph node should be noted in the diagnosis of RCC.