腎細胞癌の腫瘍側因子と予後について

Abstract

1) 1972年1月より1984年9月までに腎摘除術を施行した腎細胞癌症例56例において, 細胞型とgradeおよびpT, は, それぞれが互いに深い関連を持っていた.2) pVとgradeとの間に有意な関連が認められた.pN, pMはそれぞれpT, gradeのどちらとも関連を認めなかった.3) pT, pV, pN, pM, grade, 細胞型のいずれも予後と深い関連があった.4)以上より, pN, pMは予後を積極的に悪くする因子であるが, その評価にはfaulse negativeの危険性がある.5) pT, grade, 細胞型はより客観的な評価が可能で, 予後と密接に関係する

Fifty six patients, 40 males and 16 females, received radical nephrectomy and were diagnosed to have renal cell carcinoma pathologically at Asahi General Hospital between January, 1972 and September, 1984. The five and ten year survival rates were 44.2 and 35.7% respectively. The cancers were classified according to pTNM category and their cell type and grade were estimated. The relationship between these factors and the patient's prognosis was studied. We recognized a close correlation among pT, cell type and grade, and found that they had a serious influence on prognosis. There was a close correlation between grade and pV, but no relationship between pN, pM and grade. Cases with a positive lymph node or distant metastasis had poor prognosis. Therefore, we suggest the possibility of false negative evaluation of pN and pM, because pN and pM were estimated clinically. Consequently, we believe that the pTNM category is a good classification for evaluation tumor expansion and the prognosis.