肾癌的病理类型与预后的关系  

Prognosis of renal cell carcinoma related with its histological subtypes

作　　者：方祖军[1] 燕翔[1] 郑捷[1] 杨醌[1] 陈波[1] 姚孟树[1] 丁强[1] 张元芳[1] 

机构地区：[1]复旦大学附属华山医院泌尿外科,上海200040

出　　处：《临床泌尿外科杂志》2006年第4期262-263,共2页Journal of Clinical Urology

摘　　要：目的探讨肾癌的病理类型与预后的关系。方法对315例肾癌患者根据病情选择相应的手术治疗和病理分型,并进行病例随访。以Kaplan-Meier法计算生存率。Cox回归模型对预后影响因子进行分析。结果其中透明细胞癌202例(71.9%),颗粒细胞癌51例(18.1%),混合性腺癌15例(5.3%),乳头状腺癌7例(2.5%),集合管癌4例(1.4%),肉瘤样肾癌2例(0.7%)。Cox回归模型多因素分析显示病理类型可能是一个独立的影响预后的因子。透明细胞癌、颗粒细胞癌和混合性腺癌患者的3年、5年生存率差别无统计学意义。7例乳头状腺癌仅1例死亡。4例集合管癌和2例肉瘤样癌均已死亡,两者平均存活时间分别为6.3和5.5月。结论肾癌的病理分型对预后有一定的预测价值;乳头状腺癌预后优于其他类型肾癌;集合管癌和肉瘤样癌预后较差。Objective： To investigate the relationship of prognosis with the histological subtypes of renal cell carcinoma（RCC）. Methods：315 cases of RCC in our hospital from Jan. 1993 to Jan. 2003 were reviewed. All patients were followed up to assess survival rates. Results：281 patients underwent nephrectomy in 315 patients. The histological subtype include clear cell carcinoma （71.9 % ）, granular cell carcinoma （18.1 % ）, mixed cell carcinoma （5.3%）, papillary cell carcinoma（7 cases）,collecting duct carcinoma （4 cases） and sarcomatoid carcinoma （2 cases）. Multivariate analysis via the Cox proportional hazards model showed that the histological subtype may be a independent prognostic factor of RCC. There is no significant difference between the 3-year and 5-year survival rate of clear cell carcinoma, granular cell carcinoma and mixed cell carcinoma. Only one of the 7 patients with papillary cell carcinoma. 4 patients with collecting duct carcinoma and 2 patients with sarcomatoid died, the mean survival time was 6.3 and 6.5 months respectively. Conclusions： The histopathological differentiation of RCC into subtypes may give useful prognostic information. The prognosis of papillary cell carcinoma is better than for other subtypes and the prognosis of collecting duct carcinoma and sarcomatoid is poor.

关 键 词：肾肿瘤 病理类型 预后 

分 类 号：R737[医药卫生—肿瘤]