1734例肾细胞癌临床病理特点分析

Analysis of the clinical and pathological features of 1 734 cases of renal cell carcinoma

目的探讨肾癌发病趋势和临床病理特点,并对青年肾癌和中老年肾癌进行对比分析。方法回顾性分析天津医科大学总医院和天津医科大学第二医院2001-2011年1 734例肾细胞癌患者临床病理资料。结果本组1 734例中,青年肾癌113例,中老年肾癌1 621例。青年组透明细胞癌发病明显低于中老年组(58.4%vs.70.4%,掊2=7.332,P﹤0.05);青年组非透明细胞癌中乳头状癌明显高于中老年组(11.5%vs.2.5%,掊2=16.841,P﹤0.05)。肾癌男女发病均呈上升趋势,特别青年女性上升趋势更明显。按时间段将1 734例肾癌分为两组,2001-2006年(早期组)675例,2007-2011年(近期组)1 059例。肿瘤≤3 cm的肾癌205例,近期组所占比例(82.4%)明显高于早期组(17.6%),差异有统计学意义(掊2=44.860,P﹤0.05)。结论肾癌发病年龄呈年轻化,肿瘤≤3 cm的肾癌呈上升趋势,且青年组以乳头状癌多见,提示B超、CT体检的必要性,特别对青年应予以重视。

Objective To explore the incidence trends and the clinic-pathological features of renal cell carcinoma （RCC）, and compare the main characteristics between young adults and elder patients. Methods The clinical and patho- logical data of 1 734 cases of RCC were retrospectively analyzed. All of them were treated with surgery in the General Hospital and the Second Hospital of Tianjin Medical University during 2001 to 2011. Results 1 734 cases of RCC were operated in 11 years, which included 113 cases of young patients and l 621 eider patients. The proportion of clear cell carcinoma in the young group was distinctly lower than that in the elder group （58.4% vs. 70.4%）. For the non-clear cell carcinoma, the young group was more likely to have papillary cell carcinoma. The proportion of RCC steadily increased in our series among both male and female patients and it was more quickly increased in female than in male, which showed that the onset of age tended to be younger. Patients were divided into two groups based on the date of treatment： 675 cases during 2001-2006 （the Early group） and 1 059 cases during 2007-2011 （the Late group）. The RCC in the late group was more likely to have a h!gher incidence of small tumors （T ≤ 3 cm） than in the early group. Conclusion The age at on- set of RCC has become younger. The non-clear cell carcinoma in the young group is more likely to be papillary cell carcinoma. The incidence of RCC （T≤ 3 em） is increased, which suggests that it is necessary to apply the imaging technology such as B ultrasound and CT and to strengthen the overall physical examination. Furthermore, it is particularly important to improve the recognition of RCC in young adults.