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中华腔镜泌尿外科杂志(电子版)

中华腔镜泌尿外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (02) : 105 -109. doi: 10.3877/cma.j.issn.1674-3253.2023.02.002

临床研究

性别对Xp11.2易位型肾癌及肾透明细胞癌临床特征的影响
卓然1, 朱逸琪2, 逯艳文2, 马文亮2, 郭宏骞2, 甘卫东3,†()   
  1. 1. 210008　南京医科大学鼓楼临床医学院泌尿外科
    2. 南京大学医学院附属鼓楼医院泌尿外科
    3. 210008　南京医科大学鼓楼临床医学院泌尿外科；南京大学医学院附属鼓楼医院泌尿外科
  • 收稿日期:2022-08-22 出版日期:2023-04-01
  • 通信作者: 甘卫东
  • 基金资助:
    2022江苏省卫生健康委员会医学科研重点项目(ZD2022013)

Impact of gender in clinicopathological features of Xp11.2 translocation renal cell carcinoma and clear cell renal cell carcinoma

Ran Zhuo1, Yiqi Zhu2, Yanwen Lu2, Wenliang Ma2, Hongqian Guo2, Weidong Gan3,†()   

  1. 1. Department of Urology, Drum Tower Clinical Medical School of Nanjing Medical University
    2. Department of Urology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
    3. Department of Urology, Drum Tower Clinical Medical School of Nanjing Medical University; Department of Urology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
  • Received:2022-08-22 Published:2023-04-01
  • Corresponding author: Weidong Gan
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引用本文：

卓然, 朱逸琪, 逯艳文, 马文亮, 郭宏骞, 甘卫东. 性别对Xp11.2易位型肾癌及肾透明细胞癌临床特征的影响[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(02): 105-109.

Ran Zhuo, Yiqi Zhu, Yanwen Lu, Wenliang Ma, Hongqian Guo, Weidong Gan. Impact of gender in clinicopathological features of Xp11.2 translocation renal cell carcinoma and clear cell renal cell carcinoma[J]. Chinese Journal of Endourology(Electronic Edition), 2023, 17(02): 105-109.

目的

探讨性别对Xp11.2易位型肾癌（Xp11.2 tRCC）及肾透明细胞癌（ccRCC）临床特征的影响。

方法

回顾性分析2007年6月至2020年8月在南京大学医学院附属鼓楼医院接受手术治疗的53例Xp11.2 tRCC患者的临床资料。根据患者肿瘤最大径和手术时间，同时匹配173例ccRCC患者进行对比，分析不同性别患者的临床病理特征和预后指标。

结果

Xp11.2 tRCC患者男女比例1∶1.41，平均患病年龄（37±15）岁；而ccRCC患者男女比例2.33∶1，平均患病年龄（58±12）岁。Xp11.2 tRCC组中男女患者仅在患肾侧别上差异有统计学意义（P=0.010）；ccRCC组中男性患者呈现更高T分期（P=0.022）和AJCC分期（P=0.029）。Xp11.2 tRCC组和ccRCC组患者在性别、发病年龄、手术方式、T分期、AJCC分期和核分级差异上均有统计学意义（P<0.05）。生存分析显示Xp11.2 tRCC患者中男性和女性总生存率差异无统计学意义（P>0.05），而ccRCC患者中男性较女性总生存期（OS）更短（P<0.05）。

结论

相对于ccRCC，Xp11.2 tRCC好发于年轻女性，是一种更具侵袭性的肾癌亚型。性别可能是影响Xp11.2 tRCC发病、病理特征和预后的重要因素。

关键词: 肾肿瘤, TFE3, Xp11.2易位, 性别, 预后
Objective

To investigate the impact of gender in the clinicopathological features of Xp11.2 translocation renal cell carcinoma (Xp11.2 tRCC) and clear cell renal cell carcinoma (ccRCC).

Methods

The clinical data of 53 patients who underwent surgery for Xp11.2 tRCC in Nanjing Drum Tower Hospital from June 2007 to August 2020 were retrospectively analyzed. A total of 173 patients with ccRCC were matched according to tumor diameter and operation time. The differences in clinicopathological characteristics of male and female patients with Xp11.2 tRCC and ccRCC were compared, and the related indicators and prognosis of the two groups of renal cancer patients were further compared.

Results

The Xp11.2 tRCC group had young and female incidence advantages, while ccRCC was more common in elder and male patients. In the Xp11.2 tRCC group, the male and female patients were different significantly in terms of laterality (P=0.010). In the ccRCC group, the male patients had higher levels in terms of T stage (P=0.022) and AJCC stage (P=0.029). There were significant differences between the Xp11.2 tRCC group and the ccRCC group in terms of gender, age of onset, surgical method, T stage, AJCC stage and nuclear grade (P<0.05). Survival analysis revealed that there was no statistical difference between male and female patients in Xp11.2 tRCC group (P>0.05), while the overall survival of males in ccRCC patients was shorter than that of females (P<0.05).

Conclusions

Compared with ccRCC, Xp11.2 tRCC is more likely to occur in young and female patients, which is a more aggressive subtype of renal cell carcinoma. Sex may be an important factor affecting the pathogenesis, pathological characteristics and prognosis of Xp11.2 tRCC.

Key words: Renal carcinoma, TFE3, Xp11.2 translocation, Gender, Prognosis
表1 Xp11.2易位型肾癌男性与女性患者临床病理特征的差异
组别 例数 发病年龄[岁，(±s)] 患肾侧别(例) 手术方式(例) 肿瘤最大径[cm，(±s)] T分期(例) AJCC分期(例) 核分级(例)
右 左 根治 部分 1~2 3~4 1~2 3~4 1~2 3~4
男性 22 39±17 7 15 12 10 5.3±2.4 15 7 15 7 6 16
女性 31 35±13 21 10 19 12 5.5±3.1 24 7 19 12 12 19
统计值   t=0.849 χ2=6.664 χ2=0.241 t=-0.275 χ2=0.565 χ2=0.266 χ2=0.750
P值   0.400 0.010 0.623 0.784 0.452 0.606 0.386
表2 肾透明细胞癌男性与女性患者临床病理特征的差异
组别 例数 发病年龄[岁，(±s)] 患肾侧别(例) 手术方式(例) 肿瘤最大径[cm，(±s)] T分期(例) AJCC分期(例) 核分级(例)
右 左 根治 部分 1~2 3~4 1~2 3~4 1~2 3~4
男性 121 58±13 68 53 35 86 5.2±2.9 101 20 102 19 87 34
女性 52 58±10 30 22 20 32 5.6±2.3 50 2 50 2 42 10
统计值   t=-0.089 χ2=0.033 χ2=1.525 t=0.222 χ2=5.271 χ2=4.794 χ2=1.058
P值   0.948 0.856 0.217 0.392 0.022 0.029 0.219
表3 Xp11.2易位型肾癌和肾透明细胞癌临床病理特征的差异
组别 例数 性别(例) 发病年龄[岁，(±s)] 患肾侧别(例) 手术方式(例) 肿瘤最大径[cm，(±s)] T分期(例) AJCC分期(例) 核分级(例)
男 女 右 左 根治 部分 1~2 3~4 1~2 3~4 1~2 3~4
Xp11.2 tRCC 53 22 31 37±15 28 25 31 22 5.4±2.8 39 14 34 19 18 35
ccRCC 173 121 52 58±12 98 75 55 118 5.3±2.7 151 22 152 21 129 44
统计值   χ2=14.114 t=-8.023 χ2=0.240 χ2=12.268 t=0.199 χ2=5.685 χ2=15.658 χ2=29.419
P值   <0.001 <0.001 0.624 <0.001 0.842 0.017 <0.001 <0.001
图1 Xp11.2易位型肾癌（a）及肾透明细胞癌（b）男女患者的生存曲线
[1]
Ljungberg B, Albiges L, Abu-Ghanem Y, et al. European Association of Urology Guidelines on Renal Cell Carcinoma: The 2019 Update[J]. Eur Urol, 2019, 75(5): 799-810.
[2]
Baniak N, Barletta JA, Hirsch MS. Key renal neoplasms with a female predominance[J]. Adv Anat Pathol, 2021, 28(4): 228-250.
[3]
Liu N, Yi C, Gan W, et al. Both SUMOylation and ubiquitination of TFE3 fusion protein regulated by androgen receptor are the potential target in the therapy of Xp11.2 translocation renal cell carcinoma[J]. Clin Transl Med, 2022, 12(4): e797.
[4]
Pederzoli F, Bandini M, Marandino L, et al. Targetable gene fusions and aberrations in genitourinary oncology[J]. Nat Rev Urol, 2020, 17(11): 613-625.
[5]
Lopez-Beltran A, Scarpelli M, Montironi R, et al. 2004 WHO classification of the renal tumors of the adults[J]. Eur Urol, 2006, 49(5): 798-805.
[6]
Moch H, Cubilla AL, Humphrey PA, et al. The 2016 WHO classification of tumours of the urinary system and male genital organs-part a: renal, penile, and testicular tumours[J]. Eur Urol, 2016, 70(1): 93-105.
[7]
Simonaggio A, Ambrosetti D, Vano YA, et al. MiTF/TFE translocation renal cell carcinomas: from clinical entities to molecular insights[J]. Int J Mol Sci. 2022, 23(14): 7649.
[8]
Dong X, Chen Y, Gan W, et al. Clinicopathological features and prognosis of TFE3-positive renal cell carcinoma[J]. Front Oncol, 2022, 12: 1017425.
[9]
Ge Y, Lin X, Zhang Q, Li Z, et al. Xp11.2 translocation renal cell carcinoma with tfe3 rearrangement: Distinct morphological features and prognosis with different fusion partners[J]. Front Oncol, 2021, 11: 784993.
[10]
Scelo G, Li P, Chanudet E, et al. Variability of sex disparities in cancer incidence over 30 years: The striking case of kidney cancer[J]. Eur Urol Focus, 2018, 4(4): 586-590.
[11]
Mancini M, Righetto M, Baggio G. Gender-related approach to kidney cancer management: Moving forward[J]. Int J Mol Sci, 2020, 21(9):3378.
[12]
Lucca I, Klatte T, Fajkovic H, et al. Gender differences in incidence and outcomes of urothelial and kidney cancer[J]. Nat Rev Urol, 2015, 12(10): 585-92.
[13]
Choo MS, Jeong CW, Song C, et al. Clinicopathologic characteristics and prognosis of xp11.2 translocation renal cell carcinoma: Multicenter, propensity score matching analysis[J]. Clin Genitourin Cancer, 2017, 15(5): e819-e825.
[14]
Pereira G, Dória S. X-chromosome inactivation: implications in human disease[J]. J Genet, 2021, 100(2): 63.
[15]
Liu N, Wang Z, Gan W, et al. Renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusions: Clinical features, treatments and prognosis[J]. PLoS One, 2016,11(11): e0166897.
[16]
Rampersaud EN, Klatte T, Bass G, et al. The effect of gender and age on kidney cancer survival: younger age is an independent prognostic factor in women with renal cell carcinoma[J]. Urol Oncol, 2014, 32(1): 30.
[17]
Hagerty BL, Aversa J, Diggs LP, et al. Characterization of alveolar soft part sarcoma using a large national database[J]. Surgery, 2020, 168(5):825-30.
[18]
Zhuang W, Liu N, Guo H, et al. Gender difference analysis of Xp11.2 translocation renal cell carcinomas's attack rate: a meta-analysis and systematic review[J]. BMC Urol, 2020, 20(1): 130.
[19]
Fucic A, Gamulin M, Ferencic Z, et al. Environmental exposure to xenoestrogens and oestrogen related cancers: reproductive system, breast, lung, kidney, pancreas, and brain[J]. Environ Health, 2012, 11 (Suppl 1):S8.
[20]
Wang Y, Yang Z, Han Z, et al. Estrogen receptor beta increases clear cell renal cell carcinoma stem cell phenotype via altering the circPHACTR4/miR-34b-5p/c-Myc signaling[J].FASEB J, 2022, 36(2):e22163.
[21]
Yedidia-Aryeh L, Goldberg M. The Interplay between the Cellular Response to DNA Double-Strand Breaks and Estrogen[J]. Cells, 2022, 11(19): 3097.
[22]
Shi Q,Liu N, Gan W, et al. Estradiol increases risk oftopoisomerase IlB-mediated DNA strand breaks toinitiate Xp11.2 translocation renal cell carcinoma[J]. Cell Commun Signal, 2021, 19(1): 114.
[23]
Peired AJ, Campi R, Romagnani P, et al. Sex and Gender Differences in Kidney Cancer: Clinical and Experimental Evidence[J]. Cancers, 2021, 13(18): 4588.
[24]
Aron M, Nguyen MM, Stein RJ, et al. Impact of gender in renal cell carcinoma: an analysis of the SEER database[J]. Eur Urol, 2008, 54(1): 133-140.
[25]
Peired AJ, Campi R, Romagnani P, et al. Sex and gender differences in kidney cancer: Clinical and experimental evidence[J]. Cancers, 2021, 13: 4588.
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