性别对Xp11.2易位型肾癌及肾透明细胞癌临床特征的影响

Impact of gender in clinicopathological features of Xp11.2 translocation renal cell carcinoma and clear cell renal cell carcinoma

目的探讨性别对Xp11.2易位型肾癌(Xp11.2 tRCC)及肾透明细胞癌(ccRCC)临床特征的影响。方法回顾性分析2007年6月至2020年8月在南京大学医学院附属鼓楼医院接受手术治疗的53例Xp11.2 tRCC患者的临床资料。根据患者肿瘤最大径和手术时间,同时匹配173例ccRCC患者进行对比,分析不同性别患者的临床病理特征和预后指标。结果Xp11.2 tRCC患者男女比例1∶1.41,平均患病年龄(37±15)岁;而ccRCC患者男女比例2.33∶1,平均患病年龄(58±12)岁。Xp11.2 tRCC组中男女患者仅在患肾侧别上差异有统计学意义(P=0.010);ccRCC组中男性患者呈现更高T分期(P=0.022)和AJCC分期(P=0.029)。Xp11.2 tRCC组和ccRCC组患者在性别、发病年龄、手术方式、T分期、AJCC分期和核分级差异上均有统计学意义(P<0.05)。生存分析显示Xp11.2 tRCC患者中男性和女性总生存率差异无统计学意义(P>0.05),而ccRCC患者中男性较女性总生存期(OS)更短(P<0.05)。结论相对于ccRCC,Xp11.2 tRCC好发于年轻女性,是一种更具侵袭性的肾癌亚型。性别可能是影响Xp11.2 tRCC发病、病理特征和预后的重要因素。

Objective To investigate the impact of gender in the clinicopathological features of Xp11.2 translocation renal cell carcinoma(Xp11.2 tRCC)and clear cell renal cell carcinoma(ccRCC).Methods The clinical data of 53 patients who underwent surgery for Xp11.2 tRCC in Nanjing Drum Tower Hospital from June 2007 to August 2020 were retrospectively analyzed.A total of 173 patients with ccRCC were matched according to tumor diameter and operation time.The differences in clinicopathological characteristics of male and female patients with Xp11.2 tRCC and ccRCC were compared,and the related indicators and prognosis of the two groups of renal cancer patients were further compared.Results The Xp11.2 tRCC group had young and female incidence advantages,while ccRCC was more common in elder and male patients.In the Xp11.2 tRCC group,the male and female patients were different significantly in terms of laterality(P=0.010).In the ccRCC group,the male patients had higher levels in terms of T stage(P=0.022)and AJCC stage(P=0.029).There were significant differences between the Xp11.2 tRCC group and the ccRCC group in terms of gender,age of onset,surgical method,T stage,AJCC stage and nuclear grade(P<0.05).Survival analysis revealed that there was no statistical difference between male and female patients in Xp11.2 tRCC group(P>0.05),while the overall survival of males in ccRCC patients was shorter than that of females(P<0.05).Conclusions Compared with ccRCC,Xp11.2 tRCC is more likely to occur in young and female patients,which is a more aggressive subtype of renal cell carcinoma.Sex may be an important factor affecting the pathogenesis,pathological characteristics and prognosis of Xp11.2 tRCC.