腎細胞癌146例の病理組織学的予後決定因子 : 偶発癌と非偶発癌の比較を中心にして

Abstract

1)組織学的構築型では, 充実型は有意に予後不良であった. 2)組織学的細胞型では, 紡錘細胞型と多形細胞型は, 通常型と比較して, 有意に予後不良であった. 3)偶発癌は非偶発癌に比較して, 有意に予後良好であった. 4)偶発癌は非偶発癌に比較して明らかに腫瘍径が小さく, low stageであり, 組織学的構築型では, 乳頭型や充実型が少なく, 細胞型では, 多型細胞型や紡錘細胞型がみられず, G3やINFγも含まれていなかった. 5)偶発癌は腫瘍径の大きなものでも予後良好であった

To characterize the prognostic factors among pathological structural pattern, cell type, infiltration, and incidental or non-incidental renal cell carcinoma (RCC), we reviewed the records of 146 patients with RCC who underwent nephrectomy at our institute. The patients were 26 to 86 years old (mean age 58). The men-to-women ratio was 3.2:1. The tumor originated in the right kidney in 83 patients and in the left in 63. The solid pattern was associated with poorer survival than other patterns (p < 0.01). Spindle or pleomorphic cell type had poorer survival than common type (p < 0.01). The number of incidentally discovered RCC has increased since 1986, and survival is better than in non-incidental RCC, because of smaller tumor size, low stage tumor (stages 1, 2; 83.6%), and fewer papillary or solid type. In addition, there were no spindle or pleomorphic cell type, grade 3 or INF gamma-positive case. Survival is good even when the tumor is large.