45岁以下肾细胞癌TFE3表达的临床及预后分析

TFE3-positive renal cell carcinoma in patients under the age of 45:a clinical and prognostic analysis

目的回顾性比较分析45岁以下TFE3阳性肾细胞癌和TFE3阴性肾细胞癌患者的临床病理特征与预后情况。方法回顾2008年1月至2014年1月我院收治的57例45岁以下肾癌患者的临床资料,依据原有病理结果及TFE3免疫组化分析确定TFE3阳性肾癌、TFE3阴性肾癌,并对两组的临床病理学资料和预后情况进行比较分析。结果 TFE3阳性肾癌和TFE3阴性肾癌分别为21例和36例。TFE3阳性肾癌具有较明显的组织病理学特征,TFE3细胞核弥漫性表达;TFE3阳性肾癌中位年龄27岁,明显低于TFE3阴性肾癌41岁(P<0.001);TFE3阳性肾癌男女性别比(9∶12),与TFE3阴性肾癌男女性别比(25∶11)达到统计学差异(P=0.048);TFE3阳性肾癌Furhman分级1级占0%、2级占57.1%、3级占14.2%、4级占14.2%,TFE3阴性肾癌Furhman分级1级占27.8%、2级占55.6%、3级占8.3%、4级占8.3%,TFE3阳性肾癌组织学分级更高(P=0.005)。两组间肿瘤大小、位置、临床症状、手术方式、临床分期、5年生存率差异无统计学意义(P>0.05)。结论与TFE3阴性肾癌相比,TFE3阳性肾癌发病年龄更低,多见于女性,组织学恶性度更高,但中期随访生存期无显著差异。

Objective To compare the clinicopathological characteristics and prognosis between TFE3-positive and TFE3-negative renal cell carcinoma in patients under 45 years of age. Methods Clinical data of 57 patients with renal cell carcinoma treated during Jan. 2008 and Jan. 2014 were retrospectively analyzed. The patients were classified into TFE3-positive group （n = 21） and TFE3-negtive group （n = 36） based on the original pathological data and TFE3 immunohistochemical analysis. The cilnicopathological characteristics and survival rate of the two groups were compared. Results TFE3-positive renal carcinoma was found to have more specific histopathological features, with diffused expression of TFE3 in nuclear. Compared with TFE3-negative group, TFE3-positive group were significantly younger （26.4 ± 10.9） vs. （37.7 ± 7.3） years, P 〈 0. 001） and had lower male-female ratio （9 ： 12 vs. 25 ： 11, P=0. 048）. The Furhman grade of TFE3-positive group was 0% in grade 1, 27.8% in grade 2, 14.2% in grade 3 and 14.2% in grade 4. The Furhman grade of TFE3-negative group was 27.8% in grade 1, 55.6% in grade 2, 8.3% in grade 3, 14.2% in grade 4. TFE3-positive group had a higher histological grade （P= 0. 005）. There was no statistical difference between the two groups in tumor size, tumor location, clinical symptoms, surgical procedure, clinical stages and 5-year survival rate （P〉0.05）. Conclusion Compared to TFE3-negative renal carcinoma, TFE3-positive renal carcinoma shows earlier average age of onset, higher female incidence rate and histological grade.