Clinical features and survival analysis of clear cell papillary renal cell carcinoma: A 10-year retrospective study from two institutions.
Clinical features and survival analysis of clear cell papillary renal cell carcinoma: A 10-year retrospective study from two institutions.
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透明细胞乳头状肾细胞癌的临床特征及生存分析：两家机构的10年回顾性研究
DOI：
10.3892/ol.2018.8752
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发表时间：
2018-07
期刊：
影响因子：
2.9
通讯作者：
Li G
中科院分区：
文献类型：
--
作者：
Wang Y;Ding Y;Wang J;Gu M;Wang Z;Qin C;Han C;Li H;Liu X;Wu P;Li G
透明细胞乳头状肾细胞癌（CCPRCC）是近年来发现的肾细胞癌的一个亚型，但其临床特点尚不清楚。本研究从两个机构中筛选出26例CCPRCC。研究患者资料、组织病理学、免疫组化表型、计算机断层扫描图像和生存分析。平均年龄为53.3岁，平均肿瘤大小为2.5 cm。共有17例患者的体重指数高于正常水平。共有11例患者患有高血压，6例患者有吸烟史。组织学上，所有病例的CCPRCC表现为管状和乳头状结构，小到中等大小的立方形肿瘤细胞，细胞壁清晰，Fuhrman核分级低。所有肿瘤均被1/4厚的纤维囊包裹。免疫组化显示CK 7、CA IX和波形蛋白呈弥漫性和中度至强烈的细胞质染色，但AMACR和CD 10在所有病例中均呈阴性（有时呈局灶性阳性）。Ki 67标记指数结果显示，肾癌组织中Ki 67的表达明显低于肾透明细胞癌（2.19vs.7.07%，P<0.001）和乳头状肾细胞癌（2.19vs.6.65%，P<0.001）。影像学表现为边界光滑的小肿块，混杂强化。与CCRCC一样，CCPRCC的多相衰减曲线在皮髓质期明显增高，在肾造影期和排泄期逐渐降低。中位随访期为50个月，未观察到癌症特异性死亡或肿瘤复发。考虑到CCPRCC的良好预后，术前活检以明确诊断尤为重要。根据目前的研究结果，建议对CCPRCC患者进行肾部分切除术。如果患者不能耐受手术，可考虑进行封闭监测或射频消融。
Clear cell papillary renal cell carcinoma (CCPRCC) is a recently recognized subtype of renal cell carcinoma entity, however, little is known about its clinical features. In the present study, 26 cases of CCPRCC were screened out from two institutions. The patient data, tissue pathology, immunohistochemical phenotype, computed tomographic images and survival analysis were studied. The mean age was 53.3 years and the average tumor size was 2.5 cm. A total of 17 patients' body mass indexes were higher than the normal level. A total of 11 patients had hypertension and 6 patients had a smoking history. Histopathologically, all cases of CCPRCC exhibited a tubular and papillary architecture, small to medium-sized cuboidal tumor cells with clear cytoplasms, and a low Fuhrman nuclear grade. All tumors were encapsulated by variably thick fibrous capsules. Immunohistochemistry showed diffuse and moderate to strong cytoplasmic staining for CK7, CA IX and vimentin, but negative for AMACR and CD10 (sometimes focally positive) in all cases. According to the results of Ki67 labeling index, the expression of Ki67 in CCPRCC was much lower than that in clear cell renal cell carcinoma (CCRCC) (2.19 vs. 7.07%, P<0.001) and that in papillary renal cell carcinoma (PRCC) (2.19 vs. 6.65%, P<0.001). Radiographically, the tumors were shown as small masses with smooth contour and mixed enhancement pattern. The multiphasic attenuation curve for CCPRCC, like that for CCRCC, increased in the corticomedullary phase markedly and decreased in the nephrographic phase and excretory phase gradually. At a median follow-up period of 50 months, no cancer-specific death or tumor recurrence was observed. Considering the favorable prognosis of CCPRCC, preoperative biopsy in order to make clear the diagnosis is particularly important. In light of the present findings, partial nephrectomy for patients with CCPRCC is recommended. If the patients cannot tolerate surgery, closed monitoring or radiofrequency ablation may be considered.
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影响因子：
23.4
作者：
Moch, Holger;Cubilla, Antonio L.;Ulbright, Thomas M.
通讯作者：
Ulbright, Thomas M.
DOI：
10.1097/pas.0000000000000456
发表时间：
2015-07
期刊：
The American journal of surgical pathology
影响因子：
--
作者：
Deml KF;Schildhaus HU;Compérat E;von Teichman A;Storz M;Schraml P;Bonventre JV;Fend F;Fleige B;Nerlich A;Gabbert HE;GaBler N;Grobholz R;Hailemariam S;Hinze R;Knüchel R;Lhermitte B;Nesi G;Rüdiger T;Sauter G;Moch H
通讯作者：
Moch H
影响因子：
3.3
作者：
Munari, Enrico;Marchionni, Luigi;Chitre, Apurva;Hayashi, Masamichi;Martignoni, Guido;Brunelli, Matteo;Gobbo, Stefano;Argani, Pedram;Allaf, Mohamad;Hoque, Mohammad O.;Netto, George J.
通讯作者：
Netto, George J.
影响因子：
2.8
作者：
Alexiev, Borislav A.;Drachenberg, Cinthia B.
通讯作者：
Drachenberg, Cinthia B.
影响因子：
2
作者：
Pramick, Michelle;Ziober, Amy;Bing, Zhanyong
通讯作者：
Bing, Zhanyong