Clear cell renal cell carcinoma: validation of World Health Organization/International Society of Urological Pathology grading

被引:128
作者
Dagher, Julien [1 ,2 ,3 ]
Delahunt, Brett [1 ,4 ]
Rioux-Leclercq, Nathalie [2 ,3 ]
Egevad, Lars [5 ]
Srigley, John R. [1 ,6 ]
Coughlin, Geoffrey [7 ]
Dunglinson, Nigel [7 ]
Gianduzzo, Troy [7 ]
Kua, Boon [7 ]
Malone, Greg [8 ]
Martin, Ben [9 ]
Preston, John [8 ]
Pokorny, Morgan [7 ]
Wood, Simon [8 ]
Yaxley, John [7 ]
Samaratunga, Hemamali [1 ,10 ]
机构
[1] Aquesta Specialized Uropathol, Brisbane, Qld, Australia
[2] Rennes Univ Hosp, Rennes, France
[3] Univ Rennes, Rennes, France
[4] Wellington Sch Med & Hlth Sci, Dept Pathol & Mol Med, Wellington, New Zealand
[5] Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden
[6] Univ Toronto, Dept Lab Med & Pathobiol, Toronto, ON, Canada
[7] Wesley Hosp, Brisbane, Qld, Australia
[8] Greenslopes Hosp, Brisbane, Qld, Australia
[9] Holy Spirit Northside Hosp, Brisbane, Qld, Australia
[10] Univ Queensland, Brisbane, Qld, Australia
关键词
grading; International Society of Urological Pathology; kidney cancer; prognosis; renal cell carcinoma; World Health Organization; INTERNATIONAL-SOCIETY; SYSTEM; PARAMETERS;
D O I
10.1111/his.13311
中图分类号
Q2 [细胞生物学];
学科分类号
071009 ; 090102 ;
摘要
AimsIn 2012, the International Society of Urological Pathology (ISUP) introduced a novel grading system for clear cell renal cell carcinoma (ccRCC) and papillary renal cell carcinoma. This system is incorporated into the latest World Health Organization renal tumour classification, being designated WHO/ISUP grading. This study was undertaken to compare WHO/ISUP and Fuhrman grading and to validate WHO/ISUP grading as a prognostic parameter in a series of clear cell RCC. Methods and resultsAnalysis of 681 cases of ccRCC showed that 144 tumours could not be assigned a Fuhrman grade on the basis of ambiguous grading features. The application of WHO/ISUP grading resulted in a general down-grading of cases when compared with Fuhrman grading. In a sub-group of 374 cases, for which outcome data were available, 9.3% were WHO/ISUP grade 1, 50.3% were grade 2, 24.1% grade 3 and 16.3% grade 4, while the distribution of Fuhrman grades was 0.4% grade 1, 48.7% grade 2, 29.4% grade 3 and 21.5% grade 4. There were no recurrence/metastases amongst patients with WHO/ISUP grade 1 tumours and there was a significant difference in outcome for WHO/ISUP grades 2, 3 and 4. For Fuhrman grading the cancer-free survival was not significantly different for grade 2 and grade 3 tumours. On multivariate analysis WHO/ISUP grade and pT staging category were found to retain prognostic significance. ConclusionsThe study demonstrates that FG cannot be applied in >20% of cases of ccRCC and the WHO/ISUP provides superior prognostic information.
引用
收藏
页码:918 / 925
页数:8
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