TFE3重排型肾细胞癌的临床特征及预后分析  

Clinical characteristics and prognostic analysis of TFE3 rearranged renal cell carcinoma

作　　者：姚晓燕[1] 张胜威[3] 李醒亚[2] YAO Xiaoyan;ZHANG Shengwei;LI Xingya(Department of General Medicine,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院综合科,郑州450000 [2]郑州大学第一附属医院肿瘤科,郑州450000 [3]郑州大学第二附属医院泌尿外科

出　　处：《现代泌尿生殖肿瘤杂志》2025年第1期4-8,共5页Journal of Contemporary Urologic and Reproductive Oncology

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200410)。

摘　　要：目的通过收集TFE3重排型肾细胞癌(TFE3 rRCC)的相关数据并探讨其临床特征和预后影响因素。方法回顾性分析郑州大学第一附属医院2018年1月至2023年12月TFE3 rRCC患者的临床资料及随访信息,总结其临床特征和预后影响因素。结果本研究纳入26例患者,男11例,女15例,平均年龄(36.8±15.6)岁,其中18~59岁患者占76.9%。肿瘤直径(5.5±2.7)cm,左侧16例,右侧10例;大多数患者(61.5%)无临床症状,少数患者(34.6%)出现肉眼血尿和腰痛。本组24例行手术治疗,其中16例行腹腔镜肾根治性切除术,2例行开放性肾根治性切除术,3例行腹腔镜肾部分切除术,2例行腹腔镜肾减瘤性切除术,1例行开放性肾减瘤性切除术。术后病理分期Ⅰ期17例(65.4%),Ⅱ期2例(7.7%),Ⅲ期2例(7.7%),Ⅳ期5例(19.2%)。26例患者平均随访(44.04±20.60)个月,10例(38.5%)患者出现病情进展,3年和5年无进展生存率分别为72.9%、51.2%。单因素Cox比例风险回归分析发现,淋巴结是否转移、AJCC分期和是否伴有症状是影响患者预后的危险因素(P<0.1),进一步行多因素Cox比例风险回归分析发现,只有AJCC分期是影响PFS的独立危险因素(P<0.05)。结论TFE3 rRCC是一种临床罕见的肾细胞癌亚型,多见于女性及中青年患者。TFE3 rRCC以早期局限性肾癌为主,多表现为血尿而缺乏特异性。早期局限性TFE3 rRCC预后好,以根治性手术治疗为主,晚期TFE3 rRCC预后差,以靶向治疗和或免疫治疗为主。AJCC分期是TFE3 rRCC患者预后的独立危险因素。Objective To explore the clinical characteristics and prognostic factors of TFE3-rearranged renal cell carcinoma(TFE3 rRCC).Methods A retrospective analysis was conducted on the clinical data of TFE3 rRCC patients at our hospital from January 2018 to December 2023.The clinical features and prognostic factors were summarized.Results Among the 26 patients,there were 11 males and 15 females,and their average age was(36.8±15.6)years.Four patients(15.4%)were minors,22(84.6%)were adults,with a high proportion(76.9%)being middleaged and young adults.The tumor diameter was(5.5±2.7)cm,with 16 cases on the left side and 10 on the right.Most patients(61.5%)had no clinical symptoms,while those with symptoms mainly presented with gross hematuria and lower back pain.A total of 24 cases underwent surgical treatment,including 16 cases undergoing laparoscopic radical nephrectomy,2 cases undergoing open radical nephrectomy,3 cases undergoing laparoscopic partial nephrectomy,2 cases undergoing laparoscopic nephrectomy for tumor reduction,and 1 case undergoing open nephrectomy for tumor reduction.Postoperative pathological staging revealed 17 cases(65.4%)in stageⅠ,2 cases(7.7%)in stageⅡ,2 cases(7.7%)in stageⅢ,and 5 cases(19.2%)in stageⅣ.The average follow-up was(44.04±20.60)months,with 10 cases(38.5%)experiencing disease progression,and the 3-year and 5-year progression-free survival rates were 72.9%and 51.2%,respectively.Univariate Cox proportional hazards regression analysis found that lymph node metastasis,AJCC staging,and presence of symptoms were risk factors affecting patient prognosis(P<0.1).Further multivariate Cox proportional hazards regression analysis revealed that only AJCC staging was an independent risk factor in progression-free survival(P<0.05).Conclusions TFE3 rRCC is a rare renal malignant tumor.It is more common in females,and mostly affects middle-aged and young patients.TFE3 rRCC is primarily characterized by localized renal cancer,often presenting with hematuria and lacking specificity.Localized TFE

关 键 词：TFE3重排型肾细胞癌 临床特征 预后分析 

分 类 号：R73[医药卫生—肿瘤]