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目的探讨不同肾细胞癌亚型的临床病理学特征。方法收集肾癌患者组织标本87例,其中透明细胞癌34例,乳头状癌30例,嫌色细胞癌13例,囊性肾细胞癌10例。观察比较不同肾细胞癌亚型患者年龄、性别、临床表现、肿瘤大小、侵犯及预后情况。结果不同肾细胞癌亚型患者年龄、性别、肿瘤多发情况差异比较无统计学意义(P>0.05);囊性肾细胞患者肿瘤直径为(5.62±1.51)cm,高于其他类型肾细胞癌患者(P<0.05);透明细胞癌和乳头状癌表现为出血比例分别为47.06%和56.67%,高于嫌色细胞癌和囊性肾细胞癌患者(P<0.05),囊性变比例分别为11.76%和6.67%,低于嫌色细胞癌和囊性肾细胞癌患者(P<0.05);不同肾细胞癌亚型侵犯情况比较差异无统计学意义(P>0.05);透明细胞癌、乳头状癌、嫌色细胞癌和囊性肾细胞癌TNM分期比较差异无统计学意义(P>0.05);透明细胞癌患者3、5、10年的无瘤生存率分别为95.0%、90.3%和80.1%,乳头状癌患者3、5、10年的无瘤生存率分别为96.2%、92.4%和82.2%,囊性肾细胞癌患者3、5、10年的无瘤生存率分别为100.0%、100.0%和92.1%,均好于嫌色细胞癌患者(P<0.05)。结论透明细胞癌、乳头状癌和囊性肾细胞癌预后较好,其中透明细胞癌和乳头状癌出血表现较普遍,囊性变比例较少。
Objective To investigate the clinicopathological features of different renal cell carcinoma subtypes. Methods Totally 87 patients with renal cell carcinoma were collected, including 34 cases of clear cell carcinoma, 30 cases of papillary carcinoma, 13 cases of chromophobe carcinoma and 10 cases of cystic renal cell carcinoma. Observe and compare the age, gender, clinical manifestations, tumor size, invasion and prognosis of different renal cell carcinoma subtypes. Results There was no significant difference in the age, sex and multiple tumor occurrence among patients with different types of renal cell carcinoma (P> 0.05). The diameter of tumor in patients with cystic renal cell was (5.62 ± 1.51) cm, higher than those in other types of patients with renal cell carcinoma (P <0.05). The percentage of clear cell carcinoma and papillary carcinoma was 47.06% and 56.67% respectively, higher than those in chromophobe and cystic renal cell carcinoma (P <0.05). The percentage of cystic degeneration were 11.76% and 6.67%, respectively, lower than that of the patients with chromophobe and cystic renal cell carcinoma (P <0.05). There was no significant difference in the subtype of renal cell carcinoma between the two groups (P> 0.05) There was no significant difference in TNM staging between carcinoma and chromophobe cell carcinoma and cystic renal cell carcinoma (P> 0.05). The tumor-free survival rates at 3, 5 and 10 years in patients with clear cell carcinoma were 95.0% and 90.3%, respectively The tumor-free survival rates at 3 years, 5 years and 10 years in patients with papillary carcinoma were 96.2%, 92.4% and 82.2% respectively. The tumor-free survival rates at 3, 5 and 10 years in patients with cystic renal cell carcinoma were 100.0% , 100.0% and 92.1%, respectively, were significantly better than those of chromophobe (P <0.05). Conclusions The clear cell carcinoma, papillary carcinoma and cystic renal cell carcinoma have good prognosis, of which the manifestations of clear cell carcinoma and papillary carcinoma are more common and less cystic changes.