摘要
目的 研究肾细胞肿瘤的临床表现、组织学分型、形态学特征及预后。方法 复习229例连续肾细胞肿瘤的临床资料、大体标本、HE切片、免疫组化染色结果，按2004年WHO肾细胞肿瘤分类标准重新分类，并随访。结果 229例肾细胞肿瘤占同期肾实质肿瘤89．1％（229／257），其中223例（97．4％）为肾细胞癌，6例（2．6％）为肾嗜酸细胞腺瘤。肾细胞癌中。透明细胞癌180例（78．6％），乳头状肾细胞癌19例（8．3％），嫌色细胞癌13例（5．7％），1例嫌色细胞癌伴肉瘤变。多房性囊性肾细胞癌6例（2．6％），Xp11．2易位／TFE3基因融合相关肾细胞癌2例（0．9％），未能分类的肾细胞癌2例（0．9％），集合管癌1例（0．4％）。透明细胞癌5年生存率为75．5％；乳头状肾细胞癌5年生存率为80％；嫌色细胞癌随访6例，随访期8—57个月，1例于57个月后死于肿瘤转移；多房性囊性肾细胞癌随访2—40个月，无复发和转移。结论 肾细胞肿瘤是一组形态学上各有特征的异质性肿瘤，以恶性为主，其中透明细胞癌、乳头状肾细胞癌、嫌色细胞癌最常见。不同类型肾细胞癌预后不同。WHO肾细胞癌的组织学分型有其实用性和先进性。
Purpose To study the clinical and pathological features, histological classification and prognosis of renal cell tumors. Methods A consecutive series of 229 cases of renal cell tumors were reviewed clinically and pathologically. All cases were reclassified in accordance with the WHO classification （2004）. Results Of 229 renal cell tumors which comprised of 89. 1% （229/257） of simultaneously removed renal parenchymal neoplasms, 223 cases were classified renal cell carcinoma （ RCC）, 6 cases were oncocytoma. Of 223 RCCs, cases were histologically classified into 180 （ accounting for 78. 6% of renal cell tumors） clear cell renal cell carcinoma （CCRCC） , 19 （8.3%） papillary renal cell carcinoma （PRCC）, 13 （5.7%） chromophobe renal cell carcinoma （CRCC） , 1 case of CRCC with sarcomatoid change, 6 （2. 6% ） multilocular cystic renal cell carcinoma （MCRCC）, 2 （0. 9% ） renal cell carcinomas associated with Xpl 1.2 translocations/TFE3 gene fusions （ Xp11 RCC ）, 2 （0. 9% ） renal cell carcinoma unclassified, and 1 （0. 4% ） carcinoma of the collecting ducts Of Bellini （CCDB）. The 5-year survival for CCRCC, PRCC was 75.5%, 80%, respectively. Follow-up was available for 6 cases of CRCC and ranged from 8 ～ 57 months, and 1 died of metastasis 57 months after surgery. No evidence of recurrence and metastasis was found in MCRCC cases during the 2 ～ 40 months follow-up. Conclusions Renal cell tumors are a group of distinctive and heterogeneous entities in morphology, and malignant in the majority. CCRCC, PRCC and CRCC are the common histological subtypes. The clinical outcomes of the various subtypes are different. The new WHO classification is practical and progressive for clinical application.
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2006年第2期158-164,共7页
Chinese Journal of Clinical and Experimental Pathology
关键词
肾肿瘤
癌
肾细胞
分类
预后
kidney neoplasms
carcinoma, renal cell tumors
classification
prognosis
