肾嫌色细胞癌113例的临床特征和预后相关因素分析

Characteristics and prognosis of 113 cases of chromophobe renal cell carcinoma:a single-center study

目的分析单中心肾嫌色细胞癌的临床特征,探讨与肾嫌色细胞癌预后相关的临床指标。方法通过回顾性分析2005年1月—2015年5月在上海长海医院住院手术,且经术后病理学检查证实为肾嫌色细胞癌的113例患者的临床、病理和随访资料。研究终点为总生存期,生存分析数据采用Kaplan-Meier法进行计算,并用Log-rank法对生存率进行分析比较。结果肾嫌色细胞癌占同期所有肾细胞癌的4.8%(113/2 355),患者中位年龄为50.96岁,男女比例为1.01∶1,80例(70.8%)无症状。肾嫌色细胞癌的1、3、5年生存率分别为98.2%(108/110)、96.4%(106/110)、95.5%(105/110)。本组中Ⅰ型肾嫌色细胞癌107例,Ⅱ型肾嫌色细胞癌6例。肾嫌色细胞癌单因素Kaplan-Meier预后分析显示,Ⅱ型肾嫌色细胞癌的预后有好于Ⅰ型的趋势,但差异无统计学意义(P=0.515);不同症状、不同T分期和美国癌症联合委员会(AJCC)分期的肾嫌色细胞癌患者预后的差异均有统计学意义(P值均<0.05)。结论肾嫌色细胞癌是预后较好的肾癌亚型之一,其中Ⅱ型预后相对更好。患者的症状、肿瘤的大小和AJCC分期可以作为判断肾嫌色细胞癌预后的重要因素。

Objective To analyze clinical features and prognosis of chromophobe renal cell carcinoma （chRCC）. Methods Clinical, pathological and follow-up data were collected from 113 chROC patients who underwent surgical treatment in Shanghai Changhai Hospital between January 2005 and May 2015. The end point of the study was the death of the patients. Kaplan-Meier survival curve was used to estimate the survival rate. Prognostic factors were evaluated by Log-rank test. Results The incidence rate of chRCC was 4. 8% （ 113/2 355） in renal cell carcinoma. The median age of the patients was 50.96 years, and M/F ratio was 1.01 ： 1. Eighty patients （70.8 % ） suffered from the asymptomatic chRCC. The one-, three- and five-year survival rates were 98.2% （108/110）, 96.4% （106/110） and 95.5% （ 105/110）, respectively. There were 107 patients with type Ⅰ chRCC and 6 with type Ⅱ chRCC. Kaplan-Meier univariate analysis showed that the prognosis of type Ⅱ chRCC was better than type Ⅰ, but there was no significant difference between them （P = 0. 515）. Symptoms, T stage and American Joint Committeeon Cance （AJCC） stage were significantly associated with prognosis （all P〈 0.05）. Conclusion ChRCC is a distinct type of renal cell carcinoma exhibiting a low degree of malignancy, and the type Ⅱ has a better prognosis. Symptoms at presentation, T stage and AJCC stage are independent prognostic factors of chRCC.