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中华腔镜泌尿外科杂志(电子版) ›› 2021, Vol. 15 ›› Issue (02) : 155 -160. doi: 10.3877/cma.j.issn.1674-3253.2021.02.016

所属专题: 经典病例 文献

病例研究

Xp11.2易位/TFE3基因融合相关性肾癌两例并文献复习
郗文瑜1, 杨静1, 高健刚1,()   
  1. 1. 266071 青岛大学附属青岛市市立医院泌尿外科
  • 收稿日期:2020-09-22 出版日期:2021-04-01
  • 通信作者: 高健刚

Renal cell carcinoma associated with Xp11.2 translocations/TFE3 gene fusions: a study of 2 cases and review of literature

Wenyu Xi1, Jing Yang1, Jiangang Gao1,()   

  1. 1. Department of Urology, Qingdao Municipal Hospital of Qingdao University, Qingdao 266071, China
  • Received:2020-09-22 Published:2021-04-01
  • Corresponding author: Jiangang Gao
引用本文:

郗文瑜, 杨静, 高健刚. Xp11.2易位/TFE3基因融合相关性肾癌两例并文献复习[J]. 中华腔镜泌尿外科杂志(电子版), 2021, 15(02): 155-160.

Wenyu Xi, Jing Yang, Jiangang Gao. Renal cell carcinoma associated with Xp11.2 translocations/TFE3 gene fusions: a study of 2 cases and review of literature[J]. Chinese Journal of Endourology(Electronic Edition), 2021, 15(02): 155-160.

目的

探讨Xp11.2易位/TFE3基因融合相关性肾癌的临床病理特点、治疗及预后。

方法

对在我院确诊的2例Xp11.2易位/TFE3基因融合相关性肾癌的临床资料进行回顾性分析并对相关文献进行复习。

结果

分别发现患者例1和例2右肾、左肾占位,例1肿瘤大小约11 cm,例2约6 cm,例1和例2分别行开腹右肾、左肾根治性切除术,术后标本进行免疫组化染色均为TFE3(+),例1术后复查发现有肺转移,然后开始口服分子靶向药物,随访18个月,发现疾病再次进展,现已发现骨转移。例2术后未行进一步治疗,目前随访24个月,尚未发现局部复发及远处转移。

结论

Xp11.2易位/TFE3基因融合相关性肾癌是一种Xp11.2染色体易位导致TFE3与其他基因相融合的罕见肾癌,通常无特异性临床表现,结合影像学、组织病理学、免疫组化染色有助于确诊,在成年人中发病的恶性程度较高,手术切除患肾是治疗此类肾癌的首选方案,分子靶向药物对治疗有一定疗效。

Objective

To investigate the clinicopathological characteristics, treatment and prognosis of renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusions.

Methods

Two patients with renal cell carcinoma associated with Xp11.2 translocations/TFE3 gene fusions were diagnosed and treated in our institution. The clinical data was retrospectively analyzed, and the relevant literature was reviewed.

Results

Two patients were found to have renal occupying. The tumor of case 1 was located in the left kidney, with a diameter of about 11cm. The tumor of case 2 was located in the right kidney, with a diameter of about 6 cm. Both patients underwent radical nephrectomy. Immunohistochemical examination showed that both patients were positive for TFE3. Case 1 patient began to take targeted drug after lung metastasis was found. After 18 months of follow-up, bone metastasis had occurred. Case 2 patient did not receive further treatment, there was no recurrence or metastasis after 24 months of follow-up.

Conclusions

Renal cell carcinoma associated with Xp11.2 translocations/TFE3 gene fusion is characterized by the gene fusions between the TFE3, which is located on the chromosome Xp11.2 and a variety of fusion partners. It is a rare renal cancer, which usually has no specific clinical manifestations. The diagnosis mainly depends on imaging, histopathology, and immunohistochemical characteristics. In adults, the disease has a high degree of malignancy. Surgery is the preferred and radical cure for this type of kidney neoplasms, and molecular targeted therapy has a certain effect.

图3 例2肾癌患者术前增强CT影像学资料:左肾动脉期灌注较对侧减低,呈不均匀强化,静脉期消退
图5 例2术后病理HE染色涂片:癌组织呈巢呈团状分布,细胞呈类圆形,部分胞浆透明,异型性明显
[1]
甘卫东,曹翔,郭宏骞. MiTF家族相关性肾癌的研究进展[J/CD]. 中华腔镜泌尿外科杂志(电子版), 2014, 8(6): 1-4.
[2]
Caliò A, Segala D, Munari E, et al. Mit family translocation renal cell carcinoma: from the early descriptions to the current knowledge[J]. Cancers, 2019, 11(8): 1110.
[3]
徐林锋,杨荣,甘卫东, 等. TFE3易位性肾癌的预后系统评价[J/CD]. 中华腔镜泌尿外科杂志(电子版). 2016,1(10): 54-57.
[4]
Argani P, Antonescu CR, Illei PB, et al. Primary renal neoplasms with the ASPL-TFE3 gene fusion of alveolar soft part sarcoma: a distinctive tumor entity previously included among renal cell carcinomas of children and adolescents[J]. Am J Pathol,2001, 159(1): 179-192.
[5]
Kmetec A, Jeruc J. Xp 11.2 translocation renal carcinoma in young adults; recently classified distinct subtype[J]. Radiol Oncol, 2014, 48(2): 197-202.
[6]
Argani P, Lae M, Ballard ET, et al. Translocation carcinomas of the kidney after chemotherapy in childhood[J]. J Clin Oncol, 2006, 24(10): 1529-1534.
[7]
Kato H, Kanematsu M, Yokoi S, et al. Renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion: radiological findings mimicking papillary subtype[J]. J Magn Reson Imaging, 2011, 33(1): 217-220.
[8]
Chen X, Zhu Q, Li B, et al. Renal cell carcinoma associated with Xp11.2 translocation/TFE gene fusion: imaging findings in 21 patients[J]. Eur Radiol, 2017, 27(2): 543-552.
[9]
He J, Zhou K, Zhu B, et al. Dynamic Contrast-enhanced ct characterization of xp11.2 translocation/tfe3 gene fusions versus papillary renal cell carcinomas[J]. BioMed Res Int, 2017, 2015: 1-8.
[10]
Wang XT, Xia QY, Zhou XJ, et al. Xp11 translocation renal cell carcinoma and the mesenchymal counterparts: an evolving concept with novel insights on clinicopathologic features, prognosis, treatment, and classification[J]. Crit Rev Oncog, 2017, 22(5-6): 481-497.
[11]
Hirobe M, Masumori N, Tanaka T, et al. Clinicopathological characteristics of Xp11.2 translocation renal cell carcinoma in adolescents and adults: Diagnosis using immunostaining of transcription factor E3 and fluorescence in situ hybridization analysis[J]. Int J Urol, 2016, 23(2): 140-145.
[12]
Gaillot-Durand L, Chevallier M, Colombel M, et al. Diagnosis of Xp11 translocation renal cell carcinomas in adult patients under 50 years: interest and pitfalls of automated immunohistochemical detection of TFE3 protein[J]. Pathol Res Pract, 2013, 209(2): 83-89.
[13]
Ljungberg B, Bensalah K, Canfield S, et al. EAU guidelines on renal cell carcinoma: 2014 update[J]. Eur Urol, 2015, 67(5): 913-924.
[14]
Wang Z, Liu N, Gan W, et al. Postoperative recurrence of adult renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion[J]. J Int Med Res, 2017, 45(4): 1287-1296.
[15]
Xu L, Yang R, Wang W, et al. Laparoscopic radiofrequency ablation-assisted enucleation of Xp11.2 translocation renal cell carcinoma: A case report[J]. Oncol Lett, 2014, 8(3): 1237-1239.
[16]
黄振,荆涛,骆磊,等. Xp11.2易位/TFE3基因融合相关性肾癌与肾透明细胞癌差异性分析[J]. 临床泌尿外科杂志, 2017, 32(3): 196-199.
[17]
Armah HB, Parwani AV. Renal cell carcinoma in a 33-year-old male with an unusual morphology and an aggressive clinical course: possible Xp11.2 translocation[J]. Pathology, 2008, 40(3): 306-308.
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