Chromophobe Renal Cell Carcinoma: Histomorphologic Characteristics and Evaluation of Conventional Pathologic Prognostic Parameters in 145 Cases
Chromophobe Renal Cell Carcinoma: Histomorphologic Characteristics and Evaluation of Conventional Pathologic Prognostic Parameters in 145 Cases
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DOI：
10.1097/pas.0b013e3181831e68
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发表时间：
2008-12-01
影响因子：
5.6
通讯作者：
Moch, Holger
中科院分区：
文献类型：
--
作者：
Amin, Mahul B.;Paner, Gladell P.;Moch, Holger
综合文献表明，憎色性肾细胞癌（RCC）在生物学上是一种低恶性潜能的肿瘤，据报道其5年和10年生存率分别为78% - 100%和80% - 90%。决定进展的肿瘤预后的常规预后参数仍有待充分表征。145例临床病理特征与预后相关。患者平均年龄59岁（27 ~ 82岁），男女比例为1.1:1。大多数肿瘤界限分明，平均为8.0 cm（范围1.0 ~ 30.0 cm）： 8%和3%的患者存在多灶性和双侧性。60例（41%）为嗜酸性变异型（大于80%嗜酸性细胞），IS（12%）为经典型（大于80%苍白细胞），67例（46%）为混合型（含有苍白细胞和嗜酸性细胞的可变混合物）。嗜酸性嗜色性肾细胞癌的一个亚群包含或具有与肾嗜酸细胞瘤相似的区域。这些肿瘤更常见的是双侧（11%）和多灶性（22%），不伴有坏死或肉瘤样改变。145例肿瘤中有12例（8%）出现肉瘤样改变。按组织学分级。1% 19%, 74%， 6%为福尔曼核1级。2. 3和4。19%, 21%, 28%, 13%, 4%, 1%。3%为pT (2002) PT1a期。pT1b pT2 pT3a pT3b。pT3c。pT4肿瘤。2%的肿瘤在发病时为pNI， 2.8%的肿瘤在发病时为m1。123例患者随访（1 ~ 182个月，平均48个月，中位37个月）。20例患者出现疾病进展（局部复发、转移和/或死亡）。在单变量分析中，肿瘤大小（P = 0.025）、pT分期（P < 0.001）、宽肺泡结构（P = 0.012）、Fuhrman核分级（P < 0.001）。镜下肿瘤坏死（P = 0.001）、血管侵犯（P = 0.020）和肉瘤样改变（P = 0.001）
The aggregate literature suggests that chromophobe renal cell carcinoma (RCC) is biologically a tumor of low malignant potential with reported 5-year and 10-year survival rates of 78% to 100% and 80% to 90%, respectively. The conventional prognostic parameters that determine the Outcome of the tumors that progress remain to be fully characterized. Clinicopathologic features of 145 cases were correlated with Outcome. The mean age of the patients was 59 years (range, 27 to 82) and the male to female ratio was 1.1:1. Most tumors were well circumscribed and averaged 8.0 cm (range, 1.0 to 30.0 cm): multifocality and bilaterality were present in 8% and 3% of patients. Sixty (41%) were eosinophilic variant (greater than 80% eosinophilic cells), IS (12%) were classic type (greater than 80% pale cells), and 67 (46%) were mixed (containing variable admixture of pale and eosinophilic cells). A Subset of eosinophilic chromophobe RCC contained or had areas similar to renal oncocytomas. These tumors tended to be more commonly bilateral (11%) and multifocal (22%) and were not associated with necrosis or sarcomatoid change. Sarcomatoid change was present in 12/145 (8%) tumors. By histologic grade. 1% 19%, 74%, 6% were Fuhrman nuclear grade 1. 2. 3, and 4. Nineteen percent, 21%, 28%, 13%, 4%, 1%. and 3% were pT (2002) stage PT1a. pT1b, pT2 pT3a, pT3b. pT3c. and pT4 tumors. Two percent tumors were pNI at presentation and 2.8%) tumors were M I at presentation. Follow-up (1 to 182 mo, mean 48 mo, median 37 mo) was available in 123 cases. Disease progression (local recurrence 4, metastasis 15, and/or death 10) was seen in 20 patients. In univariable analysis, tumor size (P = 0.025) pT stage (P < 0.001), broad alveolar architecture (P = 0.012), Fuhrman nuclear grade (P < 0.001). microscopic tumor necrosis (P = 0.001), vascular invasion (P = 0.020), and sarcomatoid change (P