唐碧霞, 李彩莉, 鄢谢桥, 李思明, 迟志宏, 斯璐, 崔传亮, 毛丽丽, 连斌, 王轩, 周莉, 白雪, 郭军, 盛锡楠. 转移性乳头状肾细胞癌的临床特征及预后分析[J]. 中国肿瘤临床, 2019, 46(17): 883-886. DOI: 10.3969/j.issn.1000-8179.2019.17.736
引用本文: 唐碧霞, 李彩莉, 鄢谢桥, 李思明, 迟志宏, 斯璐, 崔传亮, 毛丽丽, 连斌, 王轩, 周莉, 白雪, 郭军, 盛锡楠. 转移性乳头状肾细胞癌的临床特征及预后分析[J]. 中国肿瘤临床, 2019, 46(17): 883-886. DOI: 10.3969/j.issn.1000-8179.2019.17.736
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Tang Bixia, Li Caili, Yan Xieqiao, Li Siming, Chi Zhihong, Si Lu, Cui Chuanliang, Mao Lili, Lian Bin, Wang Xuan, Zhou Li, Bai Xue, Guo Jun, Sheng Xinan. Clinical characteristics and prognosis of metastatic papillary renal cell carcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2019, 46(17): 883-886. DOI: 10.3969/j.issn.1000-8179.2019.17.736
Citation: Tang Bixia, Li Caili, Yan Xieqiao, Li Siming, Chi Zhihong, Si Lu, Cui Chuanliang, Mao Lili, Lian Bin, Wang Xuan, Zhou Li, Bai Xue, Guo Jun, Sheng Xinan. Clinical characteristics and prognosis of metastatic papillary renal cell carcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2019, 46(17): 883-886. DOI: 10.3969/j.issn.1000-8179.2019.17.736
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转移性乳头状肾细胞癌的临床特征及预后分析

Clinical characteristics and prognosis of metastatic papillary renal cell carcinoma

    摘要
  • 摘要:
      目的  探讨转移性乳头状肾细胞癌（papillary renal cell carcinoma，pRCC）的临床特征、酪氨酸激酶抑制剂（tyrosine kinase inhibitor，TKI）及雷帕霉素靶蛋白（mechanistic target of rapamycin kinase，mTOR）抑制剂系统性靶向治疗疗效及预后情况。
      方法  回顾性分析2003年1月至2018年3月93例北京大学肿瘤医院收治的转移性pRCC患者的临床资料，采用国际转移性肾细胞癌联合数据库（international metastatic renal cell carcinoma database consortium，IMDC）预后模型对患者进行预后危险分层。采用Kaplan-Meier法及Cox比例风险回归模型对生存及影响因素进行分析。
      结果  93例转移性pRCC患者中Ⅱ型占95.7%（89/93），Ⅰ型占4.3%（4/93），伴肉瘤分化占11.8%（11/93），中位年龄为50.0（22~87）岁，中位随访时间为23.1个月，中位总生存（overall survival，OS）时间为（31.5±5.9）个月（95% CI为19.9~43.1）。采用IMDC预后模型进行分层，低、中、高危患者分别占14.0%（13/93）、46.2%（43/93）、39.8%（37/93），低、中、高危患者的中位OS分别为（100.0±32.8）、（38.3±8.2）、（16.4±1.2）个月，高危与低、中危患者的OS相比差异具有统计学意义（P < 0.001），低危与中危患者的OS相比差异无统计学意义（P=0.015）。93例pRCC患者的一线靶向治疗的总中位无疾病进展（progression free survival，PFS）时间为（6.6±0.5）个月，低、中、高危患者一线靶向治疗的PFS分别为（17.5±5.7）、（7.1±2.3）、（5.2±1.5）个月，高危与低危患者、高危与中危患者的PFS相比差异具有统计学意义（P=0.002、P=0.01）。
      结论  转移性pRCC具有独特的生物学特点，IMDC预后模型可用于预测转移性pRCC患者的TKI一线靶向治疗的疗效和预后生存。

     

    Abstract:
      Objective  To investigate the clinical characteristics, treatment methods, and prognosis of metastatic papillary renal cell carcinoma (pRCC).
      Methods  The clinical data of metastatic pRCC patients treated at the Department of Kidney Cancer and Melanoma, Peking University Cancer Hospital, were retrospectively analyzed. The prognosis of these patients was stratified through international metastatic renal cell carcinoma database consortium (IMDC) model. Survival and influencing factors were further analyzed using the Kaplan-Meier method and Cox proportional risk regression model.
      Results  From January 2003 to March 2018, 93 patients (median age, 50.0 years) were diagnosed with metastatic pRCC:89 (95.7%) type Ⅱ cases and 4 (4.3%) typeⅠcases. The median follow-up duration was 23.1 months, with 90, 44, and 14 patients having received first-line, second-line, and third-line treatments, respectively. The median overall survival (OS) of the 93 patients was (31.5±5.9) months95% confidence interval (CI):19.9-43.1, while the median OS of patients with low-, intermediate-, and high-risk (classified as per the International Metastatic Renal Cell Carcinoma Database ConsortiumIMDC) were (100.0±32.8), (38.3±8.2), and (16.4±1.2) months, respectively (high-risk vs. low/intermediate-risk, P < 0.001; lowrisk vs. intermediate-risk, P=0.015). The median progression free survival (PFS) with first-line treatment was (6.6±0.5) months. And the median PFS of the corresponding three groups stratified by IMDC score were (17.5±5.7), (7.1±2.3), and (5.2±1.5) months, respectively (high-risk vs. low-risk, P=0.002; high-risk vs. intermediate-risk, P=0.01).
      Conclusions  Metastatic pRCC is noted to have unique biological characteristics. The IMDC model can be used to predict the efficacy of first-line treatment using tyrosine kinase inhibitors as well as the prognosis of metastatic papillary renal cell carcinoma in such patients.

     

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