Verification of the International Society of Urological Pathology recommendations in Japanese patients with clear cell renal cell carcinoma.
Verification of the International Society of Urological Pathology recommendations in Japanese patients with clear cell renal cell carcinoma.
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DOI：
10.3892/ijo.2018.4294
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发表时间：
2018-04
影响因子：
5.2
通讯作者：
Miyajima A
中科院分区：
文献类型：
--
作者：
Kim H;Inomoto C;Uchida T;Furuya H;Komiyama T;Kajiwara H;Kobayashi H;Nakamura N;Miyajima A
本研究的目的是评价2012年国际泌尿病理学会（ISUP）共识会议推荐的透明细胞肾细胞癌（ccRCC）潜在预后参数在日本人群中的有效性。我们回顾了2004 - 2014年间在东海大学医院（日本伊势原）接受根治性手术的406例日本局部或局部晚期ccRCC患者，并在术后随访> 2年。一名病理学家审查了所有组织学切片。根据2016年世界卫生组织和TNM分类重新分配形态亚型和病理T分期。根据2012年ISUP建议评估肉瘤样分化（SD）、横纹肌样分化（RD）、肿瘤坏死（TN）和微血管浸润（MVI）。核等级根据Fuhrman和ISUP分级系统重新分类。通过单变量和多变量分析评估无复发生存期（RFS）和癌症特异性生存期（CSS）。根据Fuhrman分级系统（Fuhrman组），在使用考克斯比例风险模型的多变量分析中，TN和MVI是术后复发的独立危险因素。根据ISUP分级系统（ISUP组），TN和MVI是术后复发的独立危险因素。Fuhrman组中，年龄、Fuhrman分级和TN是CSS的独立危险因素。在ISUP组中，年龄、ISUP分级和TN是CSS的独立危险因素。此外，与从Fuhrman 2级重新分类为ISUP 2级（未升级）的组相比，从Fuhrman 2级升级为ISUP 3级的组表现出较差的CSS。无论核分级如何，TN仍然是RFS和CSS的独立预测因子。据我们所知，这是第一份证明2012年ISUP建议与日本ccRCC队列临床结局之间相关性的报告。TN和升级到ISUP 3级被认为是术后预后的潜在有用的独立指标。
The aim of the present study was to evaluate the validity of potential prognostic parameters of clear cell renal cell carcinoma (ccRCC) recommended by the 2012 International Society of Urological Pathology (ISUP) Consensus Conference in the Japanese population. We reviewed 406 Japanese patients with localized or locally advanced ccRCC who underwent curative surgery during 2004–2014 at Tokai University Hospital (Isehara, Japan) and were followed up for >2 years after surgery. A single pathologist reviewed all the histological slides. Morphological subtype and pathological T stage were reassigned according to the 2016 World Health Organization and TNM classifications. Sarcomatoid differentiation (SD), rhabdoid differentiation (RD), tumor necrosis (TN) and microvascular invasion (MVI) were assessed according to the 2012 ISUP recommendations. Nuclear grade was reclassified according to both the Fuhrman and the ISUP grading systems. Recurrence-free survival (RFS) and cancer-specific survival (CSS) were assessed through univariate and multivariate analyses. According to the Fuhrman grading system (group Fuhrman), TN and MVI were independent risk factors for postoperative recurrence in the multivariate analysis using the Cox proportional hazards model. According to the ISUP grading system (group ISUP), TN and MVI were independent risk factors for postoperative recurrence. In group Fuhrman, age, Fuhrman grade and TN were independent risk factors for CSS. In group ISUP, age, ISUP grade, and TN were independent risk factors for CSS. Furthermore, the group that was upgraded from Fuhrman grade 2 to ISUP grade 3 exhibited poorer CSS compared with the group that was reclassified from Fuhrman grade 2 to ISUP grade 2 (non-upgraded). Regardless of the nuclear grade, TN remained an independent predictor of RFS and CSS. To the best of our knowledge, this is the first report to prove the correlation between the 2012 ISUP recommendations and clinical outcomes in a Japanese ccRCC cohort. TN and upgrading to ISUP grade 3 were found to be potentially useful independent indicators of postoperative prognosis.
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影响因子：
23.4
作者：
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通讯作者：
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影响因子：
6.6
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影响因子：
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通讯作者：
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