Zhou Xiao-jun
Department of Pathology, Clinical School of Medical College of Nanjing University/Nanjing Jinling Hospital, Nanjing, Jiangsu 210002, China.
Int J Surg Pathol. 2010 Dec;18(6):458-64. doi: 10.1177/1066896910375565. Epub 2010 Jul 18.
Renal cell carcinomas (RCCs) in children and adolescents are much rarer than in adults. In this age group, Xp11.2 translocation RCCs were the most common subtype of pediatric RCCs. Information regarding the clinical behavior of pediatric RCCs remains controversial because of their relatively rare incidence. The authors aimed to perform a systematic review and meta-analysis to better define the biological features of pediatric RCCs.
Eligible studies were identified through multiple search strategies. Studies were assessed for quality using the Jadad Quality Scale. Data were collected comparing overall survival (OS), disease-free survival (DFS), and stage in patients with TFE3 + pediatric RCCs and TFE3 - RCCs.
A total of 4 studies were included for meta-analysis, and pooled odds ratios (ORs) with 95% confidence interval (CI) were calculated. The meta-analysis outcomes showed that TFE3 + pediatric RCCs were significantly associated with poorer outcomes (OS and DFS) and a higher stage (III/IV) than TFE3 - RCCs (pooled ORs for each group: 4.59 [95% CI = 1.46-14.42] for OS; 5.79 [95% CI = 1.85-18.16] for DFS; and 5.89 [95% CI = 2.23-15.52] for stage). This result was also confirmed by OS and DFS curves (P = .005 and P = .001).
Xp11.2 translocation carcinomas appear to have a poorer prognosis than non-Xp11.2 translocation carcinomas in children and young adults.
儿童和青少年肾细胞癌(RCC)比成人少见得多。在这个年龄组中,Xp11.2易位性RCC是小儿RCC最常见的亚型。由于小儿RCC发病率相对较低,关于其临床行为的信息仍存在争议。作者旨在进行系统评价和荟萃分析,以更好地界定小儿RCC的生物学特征。
通过多种检索策略确定符合条件的研究。使用Jadad质量量表评估研究质量。收集数据比较TFE3+小儿RCC患者和TFE3 - RCC患者的总生存期(OS)、无病生存期(DFS)和分期。
共纳入4项研究进行荟萃分析,并计算了95%置信区间(CI)的合并比值比(OR)。荟萃分析结果显示,与TFE3 - RCC相比,TFE3+小儿RCC与更差的预后(OS和DFS)及更高的分期(III/IV期)显著相关(每组的合并OR:OS为4.59 [95%CI = 1.46 - 14.42];DFS为5.79 [95%CI = 1.85 - 18.16];分期为5.89 [95%CI = 2.23 - 15.52])。OS和DFS曲线也证实了这一结果(P = .005和P = .001)。
在儿童和年轻成人中,Xp11.2易位性癌似乎比非Xp11.2易位性癌预后更差。