透明细胞乳头状肾细胞癌的临床病理及预后特点  

Clinicopathological and prognostic characteristics of clear cell papillary renal cell carcinoma

作　　者：徐亚威 周靖程 谢海标 杨吴平 李磊 张克楠 马开访 巩艳青[1] 张争[1] 蔡林[1] 龚侃[1] Yawei Xu;Jingcheng Zhou;Haibiao Xie;Wuping Yang;Lei Li;Kenan Zhang;Kaifang Ma;Yanqing Gong;Zheng Zhang;Lin Cai;Kan Gong(Department of Urology,Peking University First Hospital,the Institute of Urology,Peking University,National Urological Cancer Center,Beijing 100034,China)

机构地区：[1]北京大学第一医院泌尿外科,北京大学泌尿外科研究所,国家泌尿男生殖系肿瘤研究中心,北京100034

出　　处：《中华医学杂志》2021年第46期3784-3788,共5页National Medical Journal of China

基　　金：国家自然科学基金(81872081);中央高校基本科研基金(BMU2018JI002);北京大学第一医院科研种子基金(2021SF01)。

摘　　要：目的分析基于中国患者人群的透明细胞乳头状肾细胞癌(CCPRCC)流行病学、临床病理及预后特点。方法纳入2016年6月至2020年6月期间在北京大学第一医院确诊的肾细胞癌患者,按照CCPRCC、透明细胞肾细胞癌(ccRCC)、乳头状肾细胞癌(pRCC)进行分组,回顾性比较分析三组患者的一般临床资料、术后病理资料及随访资料。结果共纳入CCPRCC患者18例,占该时间段内本院术后病理确诊为肾细胞癌患者的0.44%(18/4110),年龄(49.5±17.1)岁,男11例,女7例;所有的CCPRCC患者均无肾肿瘤家族史,其中只有1例CCPRCC患者具有相关的临床症状,为间断的腰腹部胀痛,而另外17例均是体检发现,无相关症状。与ccRCC及pRCC组相比,CCPRCC组患者在终末期肾病史上差异无统计学意义(χ^(2)ccRCC=0.291,χ^(2)_(pRCC)=1.161,均P>0.05)。CCPRCC组肿瘤最大径小于pRCC组(χ^(2)=-2.280,P=0.027),但与ccRCC组差异无统计学意义(χ^(2)=-0.579,P=0.565);CCPRCC组患者基本上都处于pT1a期,病理分期明显早于另外两组,且其总生存也较ccRCC组和pRCC组更好(P<0.05)。结论CCPRCC是具有独特的流行病学、临床病理及预后特点的一类肾细胞癌,患者较ccRCC和pRCC分期更早、预后更好。Objective To analyze the epidemiological,clinicopathological and prognostic characteristics of clear cell papillary renal cell carcinoma(CCPRCC)based on Chinese patient population.Method Patients with renal cell carcinoma diagnosed at Peking University First Hospital from June 2016 to June 2020 were included in this study based on the inclusion and exclusion criteria.All cases were grouped according to CCPRCC,clear cell renal cell carcinoma(ccRCC),and papillary renal cell carcinoma(pRCC),and the general clinical,postoperative pathological and follow-up data of the patients were retrospectively analyzed.Result A total of 18 CCPRCC patients were enrolled in this study,accounting for 0.44%(18/4110)of the postoperative pathologically confirmed renal cell carcinoma cases in our hospital during this time period.The age range of the included patients was 28-86 years old,with a median age of 49.5 years old.There were 11/18 males and 7/18 females.All CCPRCC patients had no family history of renal malignant tumors.Among them,only one patient with CCPRCC had related clinical symptoms,that was intermittent waist and abdomen pain,while the other 17 cases were found by physical examination without any related symptoms.Compared with ccRCC and pRCC,there was no significant difference in their end stage renal disease history(χ^(2)_(ccRCC)=0.291,χ^(2)_(pRCC)=1.161,all P>0.05).The maximum diameter of CCPRCC tumor was smaller than pRCC(χ^(2)=-2.280,P=0.027)but not significantly different from (χ^(2)_(ccRCC)=-0.579,P=0.565).The majority of patients with CCPRCC were in pT1,their pathological stage was earlier than the other two types,and their overall survival was better than ccRCC and pRCC(P<0.05).Conclusion CCPRCC is a type of renal cell carcinoma with unique epidemiology,clinicopathology and prognostic characteristics.Patients with this subtype have an earlier clinical stage and a better prognosis than ccRCC and pRCC.

关 键 词：癌 肾细胞 透明细胞乳头状肾细胞癌 临床病理特征 预后 

分 类 号：R737.11[医药卫生—肿瘤]