肾肉瘤样癌的诊断和治疗(附4例报告)  

Diagnosis and treatment of sarcomatoid renal cell carcinoma(report of 4 cases)

作　　者：刘洪年[1] 程川[1] 周玉海[1] 郭骏[1] 李金涛[1] 綦岩[1] 张维涛[1] 

机构地区：[1]泰山医学院附属医院,山东泰安271000

出　　处：《山东医药》2013年第34期27-29,共3页Shandong Medical Journal

摘　　要：目的探讨肾肉瘤样癌的诊断和治疗方法。方法对4例肾肉瘤样癌患者的临床资料进行回顾性分析。结果 4例中,单纯肉瘤样癌3例,透明细胞癌伴肉瘤样癌1例,4例肉瘤样成分角蛋白、波形蛋白均为阳性。患者主要表现为患侧腰、腹或背部疼痛、血尿及肿块。病情发展迅速,可有远处转移。4例均经术后病理检查和免疫组化检查确诊,行根治性肾切除术。3例于术后3个月内死亡,1例仍在随访中。结论肾肉瘤样癌临床少见,恶性度较高,预后差,确诊依靠病理检查。治疗以根治性手术切除为主,化疗及免疫疗法可能延长患者生存时间。Objective To investigate the diagnosis and therapeutic methods of sarcomatoid renal cell carcinoma.Methods A retrospective analysis was conducted in 4 cases of patients with sarcomatoid renal cell carcinoma.Results Among 4,3 cases were pure sarcomatoid renal cell carcinoma,and 1 case was clear-cell carcinoma with sarcomatoid renal cell carcinoma.Both cytokeratin and vimentin were positive in all the 4 cases.The main symptoms of sarcomatoid renal cell carcinoma included waist ache,abdominal pain,backache,hematuria and bossing in the abdomen.It developed rapidly with metastasis early.Four cases were confirmed by the pathological and immunohistochemical examination,and then underwent radical resection.Three cases of them died in 3 months after operation,and 1 case was still in follow-up.Conclusions The morbidity of sarcomatoid renal cell carcinoma is very low and it is higher-degree malignant tumor with bad prognosis.Radical resection is still the first choice for its treatment,chemotherapy and immunotherapy may prolong the survival time of patients.

关 键 词：肾脏肿瘤 肉瘤样癌 免疫组化 外科手术 

分 类 号：R692.9[医药卫生—泌尿科学]