透明细胞肾细胞癌（ccRCC）中的多核肿瘤细胞（MTC）尚不被充分理解。我们的研究包括2010年至2019年间一所单一机构的ccRCC病例。我们对MTC进行分类，包括带有退行性异型（MTCD）的MTC，没有异型（MTCNA）的MTC，以及带有异型（MTCA）的MTC。我们比较了MTC组之间的临床病理特征和预后。总共有256名ccRCC患者中有92人（36%）有MTC。ccRCC带有MTCD和ccRCC但没有MTC的患者具有相似的临床病理特征和预后。另外，MTCNA和MTCA与肿瘤体积较大、病理肿瘤分期较晚、世界卫生组织/国际泌尿学病理学学会核级较高以及更高的转移潜力相关（每个参数的P值均为<0.001）。总体而言，不考虑肿瘤分期，MTCA与复发率增加相关（P值为0.004），具有更高的转移潜力（P值<0.001）和较短的转移时间（P值为0.033）。单因素Cox回归分析显示，MTCNA是5年转移的重要预测因子（风险比【HR】为4.171，95% CI为1.934-8.998）；此外，MTCA是5年复发（HR为5.723，95% CI为2.495-13.124）、转移（HR为12.024，95% CI为5.966-24.232）和死亡（HR为5.661，95% CI为2.688-11.924）的重要预测因子。尽管MTCD可能与肿瘤分级无关，MTCNA和MTCA与不良预后有关。 © 2023 版权归美国临床病理学会代表牛津大学出版社所有。保留所有权利。如需授权，请发送电子邮件至：journals.permissions@oup.com。

Multinucleated tumor cells (MTCs) in clear cell renal cell carcinoma (ccRCC) are not well understood.Our study included ccRCC cases in a single institution between 2010 and 2019. We classified MTC as MTC with degenerative atypia (MTCD), MTC with no anaplasia (MTCNA), and MTC with anaplasia (MTCA). Clinicopathologic characteristics and outcomes were compared between MTC groups.In all, 92 of 256 people (36%) with ccRCC had MTC. People with ccRCC with MTCD and those with ccRCC but no MTC had similar clinicopathologic characteristics and outcomes. Also, MTCNA and MTCA were associated with larger tumor size, advanced pathologic tumor stage, higher World Health Organization/International Society of Urologic Pathologists nuclear grade, and higher metastatic potential (P < .001 for each parameter). Overall, MTCA was associated with an increased rate of recurrence (P = .004), higher metastatic potential (P < .001), and shorter time to metastasis (P = .033), regardless of tumor stage. Univariate Cox regression revealed MTCNA as a significant predictor of metastasis at 5 years (hazard ratio [HR], 4.171; 95% CI, 1.934-8.998); moreover, MTCA was a significant predictor of recurrence (HR, 5.723; 95% CI, 2.495-13.124), metastasis (HR, 12.024; 5.966-24.232), and death (HR, 5.661; 95% CI, 2.688-11.924) at 5 years.Although MTCD may not be relevant in tumor grading, MTCNA and MTCA are associated with adverse outcomes.© The Author(s) 2023. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.