A retrospective study to assess the pseudocapsule status of renal cell carcinomas and their influencing factors

doi:10.3877/cma.j.issn.1674-3253.2023.04.009

Abstract

Abstract:

Objective

To study the pathological characteristics and influencing factors of pseudocapsule (PC) in various renal cell carcinomas (RCC).

Methods

The clinicopathological data of 189 patients with RCC who underwent surgery in Nanjing Drum Tower Hospital between January 2019 and January 2020 were retrospectively analyzed.

Results

A total of 189 patients were included in the study, including 169 clear cell renal cell carcinomas (ccRCC), 13 papillary renal cell carcinomas (pRCC) and 7 chromophobe renal cell carcinomas (chRCC). The mean tumor diameter and mean PC thickness was (3.91±1.66) cm and (0.38±0.23) mm, respectively. On histopathology, complete PC was found in 119 tumors, PC invasion in 47 patients and no PC was found in 23 patients. The pRCC and chRCC, higher pathological stage and nuclear grade, instead of tumor diameter, were related to the PC invasion (P<0.05). The proportions of PC invasion in ccRCC, pRCC and chRCC were 40/169(23.7%), 7/13(53.8%) and 0/7(0%), respectively. Logistic regression analysis showed that no PC was more likely to occur in pRCC, chRCC and small tumors (≤4 cm). 9.5% of ccRCC, 30.1% of pRCC and 42.9% of chRCC had no PC.

Conclusions

The status of PC in renal cell carcinoma is related to pathological type, tumor diameter, pathological stage and nuclear grade. Meanwhile, pRCC was prone to have PC invasion and the absence of PC was more likely to occur in chRCC.

Key words: Renal carcinoma, Renal capsule, Pseudocapsule, Pathology, Tumor invasion, Enucleation of renal tumor

Xiang Dong, Wenliang Ma, Changwei Ji, Xiaogong Li, Gutian Zhang, Weidong Gan, Hongqian Guo. A retrospective study to assess the pseudocapsule status of renal cell carcinomas and their influencing factors[J]. Chinese Journal of Endourology(Electronic Edition), 2023, 17(04): 356-360.

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URL: https://zhqjmnmwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3253.2023.04.009

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References 18

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变量	数值
性别（例）
男	123（65.1%）0
女	66（34.9%）
年龄[岁，(±s)]	55.8±12.6
侧别（例）
左	95（50.3%）
右	94（49.7%）
手术方式（例）
根治	30（15.9%）
剜除	141（74.6%）0
部分切	18（9.5%）0
肿瘤直径[cm，(±s)]	3.91±1.66
假包膜厚度[mm，(±s)]	0.38±0.23
假包膜状态（例）
缺失	23（12.2%）
完整	119（63%）00.
侵犯	47（24.9%）
肿瘤生长方式（例）
内生型	8（4%）0.
外生型	181（96%）00.
病理类型（例）
肾透明细胞癌	169（89.4%）0
肾乳头状细胞癌	13（6.9%）0
肾嫌色细胞癌	7（3.7%）
核分级（例）
Ⅰ	43（22.8%）
Ⅱ	103（54.5%）0
Ⅲ	41（21.7%）
Ⅳ	2（1.1%）
T分期（例）
T_1a	117（61.9%）0
T_1b	61（32.3%）
T_2a	7（3.7%）
T_3a	4（2.1%）
AJCC分期（例）
Ⅰ	176（93.1%）0
Ⅱ	7（3.7%）
Ⅲ	6（3.2%）

变量	数值
性别（例）
男	123（65.1%）0
女	66（34.9%）
年龄[岁，(±s)]	55.8±12.6
侧别（例）
左	95（50.3%）
右	94（49.7%）
手术方式（例）
根治	30（15.9%）
剜除	141（74.6%）0
部分切	18（9.5%）0
肿瘤直径[cm，(±s)]	3.91±1.66
假包膜厚度[mm，(±s)]	0.38±0.23
假包膜状态（例）
缺失	23（12.2%）
完整	119（63%）00.
侵犯	47（24.9%）
肿瘤生长方式（例）
内生型	8（4%）0.
外生型	181（96%）00.
病理类型（例）
肾透明细胞癌	169（89.4%）0
肾乳头状细胞癌	13（6.9%）0
肾嫌色细胞癌	7（3.7%）
核分级（例）
Ⅰ	43（22.8%）
Ⅱ	103（54.5%）0
Ⅲ	41（21.7%）
Ⅳ	2（1.1%）
T分期（例）
T_1a	117（61.9%）0
T_1b	61（32.3%）
T_2a	7（3.7%）
T_3a	4（2.1%）
AJCC分期（例）
Ⅰ	176（93.1%）0
Ⅱ	7（3.7%）
Ⅲ	6（3.2%）

	假包膜侵犯	假包膜完整	P值
例数	47	119
肿瘤直径[cm，(±s)]	4.32±2.16	3.96±1.44	0.290
肿瘤生长方式（例）			0.690
内生型	03	05
外生型	44	1140
病理类型（例）			0.002
肾透明细胞癌	40	1130
肾乳头状细胞癌	07	02
肾嫌色细胞癌	00	04
病理分期（例）			0.014
T_1a	25	74
T_1b	15	41
T_2a	03	04
T_3a	04	00
核分级（例）			0.039
Ⅰ	06	26
Ⅱ	24	73
Ⅲ	16	19
Ⅳ	01	01

	假包膜侵犯	假包膜完整	P值
例数	47	119
肿瘤直径[cm，(±s)]	4.32±2.16	3.96±1.44	0.290
肿瘤生长方式（例）			0.690
内生型	03	05
外生型	44	1140
病理类型（例）			0.002
肾透明细胞癌	40	1130
肾乳头状细胞癌	07	02
肾嫌色细胞癌	00	04
病理分期（例）			0.014
T_1a	25	74
T_1b	15	41
T_2a	03	04
T_3a	04	00
核分级（例）			0.039
Ⅰ	06	26
Ⅱ	24	73
Ⅲ	16	19
Ⅳ	01	01

变量	OR	95%CI	P值
性别（男/女）	2.455	0.960~6.278	0.061
病理类型（透明细胞癌/非透明细胞癌）	6.645	02.008~21.992	0.002
肿瘤直径（≤4 cm/> 4 cm）	0.281	0.091~0.875	0.028
核分级（Ⅰ、Ⅱ/Ⅲ、Ⅳ）	1.236	0.399~3.823	0.713

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