腎癌に関する臨床統計的観察 --組織像と予後を中心として--

Abstract

Pathohistological studies on the malignancy of renal cell carcinoma, which might give influences on the prognosis of patients, were carried out on total of 52 cases treated at the urology department of Kyoto University Hospital. The results are summarized as follows. 1) Classification of all cases by cell type of the tumors showed clear-cell type 12 cases (23.1%), granular cell type 21 cases (40.4%) and mixed type 19 cases (36.5%) (Table 3). Five year survival rate in each group was 58.4%, 53.1% and 22.7% respectively (Table 4, 5, 6, Fig. 2). Five year survival rate of pure type, which contains clear-cell type or granular-cell type, was 54.6% (Table 20, Fig. 8). 2) Presence or absence of intravascular tumor-cell emboli in the renal parenchyma, renal tumor and fat capsule gave a high significance on prognosis (Table 8, Fig. 3). Cases with tumor-cell emboli had worse prognosis than without emboli. Five year survival rate in each group were 22.6% and 71.7%. 3) Prognosis of renal cell tumors encapsulated with fibrous tissue was better than that of infiltrative, non-capsulated ones. Five year survival rate of encapsulated group was 49.5% and that of infiltrated group was 30.0% (Table 10, Fig. 4). 4) Presence or absence of necrosis or hemorrhage in the renal cell tumor did not give much significance on prognosis. Based on the above-mentioned findings, it was concluded that the histological pictures which may affect the prognosis of renal cell tumor are a) cell type of the tumor; namely, clear-cell type or granular-cell type, pure type or mixed type, b) tumor cell emboli in the renal parenchyma, renal tumor or fat capsule, and c) encapsulated by fibrous tissue or not.