Renal Hücreli Karsinom Vakalarının Patoloji Raporlarında Taranması

Abstract

Amaç: Böbrekte görülen renal hücreli karsinom tüm malign tümörlerin % 1- 3’ ünü teşkil eder. Renal hücreli karsinomların histolojik olarak %80’ ini berrak hücreli tip oluşturmaktadır. Renal hücreli karsinomlarda nükleus ile alakalı olan Fuhrman derecelendirme sistemi, prognozu tahmin etmede önemli bir belirteçtir. Bu yazıda 2015- 2022 yılları arasındaki böbrek hücreli karsinom tanılı vakalar patoloji raporları üzerinden hastane dijital ortamında taranmış elde edilen veriler ve aralarındaki ilişkiler literatür eşliğinde tartışılmıştır. Gereç ve Yöntem: Ocak 2015- ocak 2022 yılları arasındaki 318 renal hücreli karsinom vakası hastane dijital ortamında taranarak belirlendi. İstatistiksel analiz için SPSS 15.0 for Windows programı kullanıldı. Bağımsız gruplarda oranlar Ki Kare testi ile karşılaştırıldı. İstatistiksel alfa anlamlılık seviyesi p< 0,05 olarak kabul edildi. Bulgular: 213’ ü erkek ve 105’ i kadın olmak üzere 318 renal hücreli karsinom vakası vardı. Tümörlerin 156’ sı sol; 155’ i sağ tarafta yerleşmişti. Histolojik tiplerden en sık görüleni berrak tip böbrek hücreli karsinom olup sayısı 195 (% 61,3)’ ti. En sık Fuhrman derece 2 görülmüş ve sayısı 137’ ti. 195 berrak hücreli renal hücreli karsinomun 190’ında derece belirtilmişti. Sonuç: 213’ ü erkek ve 105’ i kadın olmak üzere erkeklerde kadınlardan yaklaşık iki kat daha fazla vaka görüldü. Histolojik tiplerde Fuhrman derecelerinde istatistiksel olarak anlamlı fark tespit edildi (p=0,002). Grade 1 berrak papiller tipte daha yüksek, grade 2 ise berrak tip ve papiller renal hücreli karsinomda daha yüksekti. Nekroz oranlarında histolojik alt tiplere göre istatistiksel olarak anlamlı fark tespit edildi (p=0,043).

Keywords

• Renal hücreli karsinom
• Berrak hücreli Renal hücreli karsinom
• prognoz

Screening of Renal Cell Carcinoma Cases in Pathology Reports

Abstract

Objective: Renal cell carcinoma in the kidney accounts for 1-3% of all malignant tumors. Histologically, 80% of renal cell carcinomas are clear cell type. The Fuhrman grading system is related to the nucleus in renal cell carcinomas. Furthermore, it is a significant indicator in predicting prognosis. This study scanned the cases diagnosed with renal cell carcinoma between 2015 and 2022 from the hospital’s digital environment from pathology reports and discussed the relationships between them together with the literature. Material and Method: The hospital’s digital environment had 318 renal cell carcinoma cases between January 2015 and January 2022. SPSS 15.0 for Windows program was used for statistical analysis. The ratios in independent groups were compared with the Chi-Square test. Statistical alpha significance level was accepted as p< 0.05. Results: There were 318 cases of renal cell carcinoma, 213 were male, and 105 were female. 156 of the tumors were located on the left; whereas 155 were on the right side. The most common histological type was clear-type renal cell carcinoma, with 195 incidences (61.3%). Fuhrman grade 2 was the most common and the number was 137. Grading was performed in 190 of 195 clear cell renal cell carcinomas. Conclusion: There were approximately twice as many cases in men as in women, with 213 men and 105 women. There was a statistically significant difference between Fuhrman grades in different histology types (p=0.002). Grade 1 was higher in clear papillary, grade 2 was higher in clear type and papillary renal cell carcinoma. According to histological subtypes, necrosis rates differed significantly (p=0.043).

Keywords

• Renal cell carcinoma
• clear cell carcinoma
• prognosis

References

1. Muglia VF, Prando A. Renal cell carcinoma: histological classification and correlation with imaging findings . Radiol Bras. 2015;48(3):166-174. doi:10.1590/0100-3984.2013.1927
2. Zhang L, Zha Z, Qu W, Zhao H, Yuan J, Feng Y, et al. Tumor necrosis as a prognostic variable for the clinical outcome in patients with renal cell carcinoma: A systematic review and meta-analysis. BMC Cancer. 2018;18(1). doi:10.1186/s12885-018-4773-z
3. Song T, Yin Y, Liao B, Zheng S, Wei Q. Capsular invasion in renal cell carcinoma: A meta-analysis. Urol Oncol. 2013;31(7):1321-1326. doi: 10.1016/j.urolonc.2011.12.019.
4. Zhao Y, Chen H, Xıe Y, Zhang C, Hou Y, Jın M. Clinicopathologic features and prognostic factors in patients with renal cell carcinoma with sarcomatoid differantiation. APMIS. 2020;128(5):378-386. doi:10.1111/apm.13035
5. Aron M, Nguyen MM, Stein RJ, Gill IS. Impact of Gender in Renal Cell Carcinoma: An Analysis of the SEER Database. Eur Urol. 2008;54(1):133-142. doi:10.1016/J.EURURO.2007.12.001
6. Zhi H, Feng M, Liu S, Na T, Zhang N, BiLiGe WE. Prognostic Significance of Sarcomatoid Differentiation in Patients With Metastatic Renal Cell Carcinoma: A Systematic Review and Meta-Analysis. Front Oncol. 2020;10. doi:10.3389/fonc.2020.591001
7. Devrim T. Böbrek Tümörü Vakalarının Retrospektif Olarak Değerlendirilmesi. Kırıkkale Üni Tıp Der. 2019;21(2):212-217. doi:10.24938/kutfd.552211
8. Uçar M, Soyupek S, Oksay T, Özorak A, Güzel A, Öztürk Sefa A, et al. Renal kitle nedeniyle radikal nefrektomi yapılan hastaların tümör karakteristiklerinin değerlendirilmesi; 18 yıllık sonuçlarımız. Med J SDU. 2019;26(3):288-94. doi:10.17343/sdutfd.460209

9. Sun M, Abdollah F, Bianchi M, Trinh Quoc-D, Jeldres C, Tian Z, et al. A Stage-for-Stage and Grade-for-Grade Analysis of Cancer-Specific Mortality Rates in Renal Cell Carcinoma According to Age: A Competing-Risks Regression Analysis. Eur Urol. 2011;60(6):1152-1159. doi:10.1016/J.EURURO.2011.07.064
10. Andreiana BC, Emilian Stepan A, Mărgăritescu C, Taisescu O, Osman A, Simionescu C. Original Paper Histopathological Prognostic Factors in Clear Cell Renal Cell Carcinoma. Curr Health Sci J. 2018;44(3). doi:10.12865/CHSJ.44.03.01
11. Alanee S, Nutt M, Moore A, Holland B, Dynda D, Wilber A et al. Partial nephrectomy for T2 renal masses: contemporary trends and oncologic efficacy. Int Urol Nephrol. 2015;47(6):945-950. doi:10.1007/s11255-015-0975-3
12. Ni D, Ma X, Li HZ, Y Gao, XT Li, Y Zhang, et al. Factors Associated with Postoperative Renal Sinus Invasion and Perinephric Fat Invasion in Renal Cell Cancer: Treatment Planning Implications. Oncotarget. 2017;15;9(11):10091-99. doi: 10.18632/oncotarget.23497
13. Swami U, Nussenzveig RH, Haaland B, Agarwal N. Revisiting AJCC TNM staging for renal cell carcinoma: quest for improvement. Ann Transl Med. 2019;7(S1):S18-S18. doi:10.21037/atm.2019.01.50
14. Cornejo KM, Dong F, Zhou AG, Wu CL, Young RH, Braaten K et al. Papillary renal cell carcinoma: correlation of tumor grade and histologic characteristics with clinical outcome. Hum Pathol. 2015;46(10):1411-1417. doi:10.1016/J.HUMPATH.2015.07.001
15. Chen L, Ma X, Li H, Gu L, Li X, Gao Yu, et al. Influence of tumor size on oncological outcomes of pathological T3aN0M0 renal cell carcinoma treated by radical nephrectomy. PLoS One. 2017;12(3). doi:10.1371/journal.pone.0173953
16. Pecoraro A, Deuker M, Rosiello G, Stolzenbach F, Luzzago S, Tian Z, et al. Comparison between small renal masses 0-2 cm vs. 2.1-4 cm in size: A population-based study. Urologic Oncology: Seminars and Original Investigations. 2021;39(4):239.e1-239.e7. doi:10.1016/J.UROLONC.2021.01.003
17. Rodríguez-Cabello MA, Laso-García I, Donis-Canet F, Gómez-Dos-Santos V, Varona-Crespo C, Burgos-Revilla FJ. Renal cell carcinoma with vascular invasion: Mortality and prognostic factors. Actas Urológicas Españolas (English Edition). 2017;41(2):132-138. doi:10.1016/J.ACUROE.2016.12.00