針對嫌色腎細胞癌比較富爾曼核系統及嫌色腎細胞癌病理分級系統的評估結果
林祖鋒1、林文榮1,2、陳建志1,2、戴舜涵3、孫芳如4,5、蔡維恭1,2、邱文祥1,2,6
1馬偕紀念醫院 泌尿科；2馬偕醫學院；4馬偕醫院 病理科；
5馬偕醫護管理專科學校化妝品應用與管理科；6陽明醫學院
Comparison of Fuhrman Nuclear Grade and Chromophobe Tumor Grade For Chromophobe Renal Cell Carcinoma
Tsu-Feng Lin1, Wun-Rong Lin1,2, Marcelo Chen1,2, Shuen-Han Dai3, Fang-Ju Sun4,5, Wei-Kung Tsai1,2, Allen W. Chiu1,2,6
1 Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan
2 Mackay Medical College, Taipei, Taiwan
3 Department of Pathology, Mackay Memorial Hospital, Taipei, Taiwan
4 Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
5 MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
6 School of Medicine, National Yang-Ming University, Taipei, Taiwan
Background: Chromophobe renal cell carcinoma (chRCC) has a favorable prognosis. Due to irregular nuclei and nuclear pleomorphism, chRCC has a high Fuhrman nuclear grade (FNG). The chromophobe tumor grade (CTG) is a novel three-tier grading system that has been reported to be a better prognosticator than the traditional FNG. We compared the two nuclear grading systems in terms of the patients’ clinical outcomes.
Patients and Method: We performed this retrospective chart review of all patients with chRCC from 2000 to 2017. All pathologic features and CTG and FNG results were re-evaluated.
Result: Eighteen patients were collected with a mean follow-up of 70.6 months. The nuclear grading distribution was as follows: FNG 2, 56%, FNG 3, 39%, FNG 4, 5%; CTG 1 78%, CTG 2 17%, CTG 3 6%. Only one patient died. He had adrenal invasion, lung metastasis, sarcomatoid change and tumor necrosis, and the tumor was graded as FNG 4 and CTG 3. Overall survival was associated with both FNG and CTG.
Conclusion: Chromophobe RCC was associated with a low rate of cancer-specific death and sarcomatoid differentiation. Both FNG and CTG were associated with overall survival.