Chromophobe renal cell carcinoma in Iceland: An epidemiological and clinicopathological study
Chromophobe renal cell carcinoma in Iceland: An epidemiological and clinicopathological study
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DOI：
10.3109/00365599.2011.579576
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发表时间：
2011-11-01
影响因子：
--
通讯作者：
Gudbjartsson, Tomas
中科院分区：
文献类型：
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作者：
Ingimarsson, Johann P.;Hardarson, Sverrir;Gudbjartsson, Tomas
Objective.大量研究表明，罕见的嫌色细胞肾细胞癌（CRCC）比其他更常见的肾细胞癌亚型，透明细胞肾细胞癌（CCRCC）和乳头状肾细胞癌（PRCC）具有更有利的预后。然而，这些研究通常涉及选定的患者队列，而不是整个人群。该研究比较了CRCC患者与其他两种主要组织学亚型患者，并建立了基于人群的年龄标准化发病率（ASR）。材料和方法。在1971年至2005年冰岛诊断的828例组织病理学确诊的RCC中，确定了15例CRCC病例。组织学材料进行了审查，TNM系统用于分期和癌症特异性生存估计。单因素和多因素分析用于比较CRCC与CCRCC（n = 740）和PRCC（n = 66）。平均随访6.7年。结果农村信用社占农村信用社的1.8%，年平均ASR为0.17/10万。与其他亚型相比，CRCC被偶然发现的频率较低（7% vs 29%，p = 0.02），但更常在较低的分期被诊断（73% vs 45%，I + II期，p < 0.001）。一名患者同步转移，另一名患者复发CRCC;两人均死于CRCC。CRCC、CCRCC和PRCC的5年生存率分别为86%、59%和50%（p = 0.004）。校正TNM分期（比值比1.98）后，多变量分析未显示CRCC亚型是生存的独立预测因素。结论CRCC是一种罕见的肿瘤，每年的ASR为0.17/100 000。这些肿瘤通常表现出症状，尽管其阶段低于其他RCC亚型。CRCC亚型的更有利的生存似乎可以解释为这些肿瘤在低阶段被诊断。这些发现可能表明CRCC具有不同的生物学行为。
Objective. Numerous studies have suggested that the rare chromophobe renal cell carcinoma (CRCC) has a more favourable prognosis than the other more common subtypes of RCC, clear cell RCC (CCRCC) and papillary RCC (PRCC). These studies have, however, usually involved selected patient cohorts and not whole populations. This study compared CRCC patients with patients with the other two major histological subtypes and established a population-based age-standardized incidence rate (ASR). Material and methods. Of 828 histopathologically confirmed RCCs diagnosed between 1971 and 2005 in Iceland, 15 CRCC cases were identified. Histological material was reviewed, the TNM system was used for staging and cancer-specific survival was estimated. Univariate and multivariate analysis was used to compare CRCC to both CCRCC (n = 740) and PRCC (n = 66). Mean follow-up was 6.7 years. Results. CRCC accounted for 1.8% of RCCs, the ASR being 0.17/100 000 per year. Compared to other subtypes, CRCC was detected incidentally less often (7% vs 29%, p = 0.02), but was more often diagnosed at lower stages (73% vs 45% at stage I + II, p < 0.001). One patient had synchronous metastasis and another developed recurrent CRCC; both died of CRCC. Five-year survival for CRCC, CCRCC and PRCC was 86%, 59% and 50%, respectively (p = 0.004). After correcting for TNM stage (odds ratio 1.98), multivariate analysis did not indicate that CRCC subtype was an independent predictive factor for survival. Conclusion. CRCC is a rare neoplasm with an ASR of 0.17/100 000 per year. These tumours often present with symptoms despite being at lower stages than the other RCC subtypes. The more favourable survival of the CRCC subtype appears to be explained by these tumours being diagnosed at low stages. These findings may suggest that CRCC has a different biological behaviour.