回顾性评估肾细胞癌假包膜状态及其影响因素

A retrospective study to assess the pseudocapsule status of renal cell carcinomas and their influencing factors

目的研究假包膜(PC)在不同肾细胞癌(RCC)中的特点,探究影响肿瘤PC状态的影响因素。方法回顾性分析2019年1月至2020年1月于南京鼓楼医院行手术治疗的189例RCC患者的临床及病理资料。结果研究共纳入189例患者,包括肾透明细胞癌(ccRCC)患者169例,肾乳头状细胞癌(pRCC)患者13例,肾嫌色细胞癌(chRCC)7例。平均肿瘤直径(3.91±1.66)cm,平均PC厚度(0.38±0.23)mm。其中PC缺失23例,PC完整119例,PC侵犯47例。研究发现肿瘤直径和生长类型与PC侵犯无关,非透明细胞癌病理类型,更高的病理分期及核分级与PC侵犯有关(P<0.05)。PC侵犯在ccRCC、pRCC和chRCC中的比例分别为40/169(23.7%),7/13(53.8%)和0/7(0%)。Logistic回归分析表明,非透明细胞癌肿瘤和肿瘤较小者(≤4 cm)更容易发生PC缺失(P<0.05)。9.5%的ccRCC、30.1%的pRCC及42.9%的chRCC出现PC的缺失。结论肾细胞癌中PC状态和病理类型、肿瘤直径、病理分期及核分级多种因素有关,其中pRCC最容易发生PC的侵犯,而PC的缺失在chRCC中更为常见。

Objective To study the pathological characteristics and influencing factors of pseudocapsule(PC)in various renal cell carcinomas(RCC).Methods The clinicopathological data of 189 patients with RCC who underwent surgery in Nanjing Drum Tower Hospital between January 2019 and January 2020 were retrospectively analyzed.Results A total of 189 patients were included in the study,including 169 clear cell renal cell carcinomas(ccRCC),13 papillary renal cell carcinomas(pRCC)and 7 chromophobe renal cell carcinomas(chRCC).The mean tumor diameter and mean PC thickness was(3.91±1.66)cm and(0.38±0.23)mm,respectively.On histopathology,complete PC was found in 119 tumors,PC invasion in 47 patients and no PC was found in 23 patients.The pRCC and chRCC,higher pathological stage and nuclear grade,instead of tumor diameter,were related to the PC invasion(P<0.05).The proportions of PC invasion in ccRCC,pRCC and chRCC were 40/169(23.7%),7/13(53.8%)and 0/7(0%),respectively.Logistic regression analysis showed that no PC was more likely to occur in pRCC,chRCC and small tumors(≤4 cm).9.5%of ccRCC,30.1%of pRCC and 42.9%of chRCC had no PC.Conclusions The status of PC in renal cell carcinoma is related to pathological type,tumor diameter,pathological stage and nuclear grade.Meanwhile,pRCC was prone to have PC invasion and the absence of PC was more likely to occur in chRCC.