多房囊性肾细胞癌六例报告并文献复习  

Multilocular cystic renal cell carcinoma:6 cases report and literature review

作　　者：肖宁[1] 周兴[1] 曾格瓦[1] 王东辉[1] 赵晓昆[2] 蒋雷鸣[3] 张天禹[3] 覃展偶[3] 

机构地区：[1]广州医科大学附属第二医院泌尿外科,广东广州510260 [2]中南大学湘雅二医院泌尿外科,湖南长沙410011 [3]桂林医学院附属医院泌尿外科,广西桂林541001

出　　处：《中华肿瘤防治杂志》2014年第6期464-468,共5页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的：回顾性分析多房性囊性肾癌（multilocular cystic renal cell carcinoma，MCRCC）的临床资料，探讨MCRCC的诊断及治疗。方法：选取2009—2013年中南大学湘雅二医院（3例）、桂林医学院附属医院（2例）及广州医科大学附属第二医院泌尿外科（1例）收治的MCRcC患者6例。男4例，女2例，平均年龄47．2岁。4例因其他疾病、2例因腰部不适感行B超检查发现肾囊肿。术前均行CT检查，Bosniak肾囊肿分型：Ⅱ型2例，ⅡF型1例，Ⅲ型3例。6例患者中4例行肾切除术，1例行肾部分切除，1例术中病检为单纯性肾囊肿，行去顶减压术，术后病理确诊为MCRCC，二次手术行肾切除。结果：6例患者术后病理均确诊为MCRCC，肿瘤最大直径为2．7～8．0cm，平均4．5cm。TNM分期，T1N0M05例，T2N0M01例。内部呈多房性，囊壁光滑，内容物为淡黄色浆液或胶状液体。镜下可见多个囊腔，囊壁可见局灶性具有肾透明细胞癌特征的细胞。病理分级G。5例、G：1例。随访2～46个月，平均25．4个月，均无瘤存活，未见复发和转移。结论：MCRCC是肾细胞癌的一种分型，恶性度低，预后好。通过CT扫描并采用高分辨率电脑阅片提高术前诊断能力，结合其Bosniak肾囊肿分型，选择适合病例行肾单位保留手术或肾切除术。OBJECTIVE： To explore preoperative diagnosis and treatment of multilocular cystic renal cell carcinoma （MCRCC） ,the clinical data of MCRCC was retrospectively analysed. METHODS： Institutional databases were searched for the period between 2009 and 2013 to identify 6 cases of MCRCC （3 cases Second Xiangya Hospital of Central South U- niversity,2 cases from Hospital affiliated to GuiLin Medical College, 1 case from second Hospital affiliated to GuangZhou Medical University）, four male and two female adults （age 36-62 years, average 47.2 years）. The renal tumor was inci- dentally discovered during laboratory workup for different diseases in 4 patients and for flank discomfort in 2 patients with abdominal ultrasound. Of 6 confirmed cases of MCRCC,imaging revealed 2 lesions were Bosniak category Ⅱ , 1 was Bosni- ak category Ⅱ F,and 3 were Bosniak category Ⅲ. Nephroectomy was performed on 4 cases, partial nephroectomy was of- fered to one case,one case was performed nephroectomy after laparoscopic renal cyst decortication because the postopera- tive pathological examination revealed MCRCC. RESULTS： Postoperative histological examination showed the presence of MCRCC in all cases （average size 4.5 cm,range 2.7-8.0 cm） ,in which the TNM stage of 5 cases was T1 N0 M0 and an- other was T2 N0 M0. Macroscopically,cases were consist exclusively of variably sized cysts that were separated by thin and smooth septa and filled with clear,serous,or gelatinous yellow fluid. The clusters of tumor cells similar to renal clear cell carcinoma were found in the septa of tumor. For pathological grade,5 cases were grade G1 and 1 case was G2. All patients were followed up and remained tumor free for an average of 25.4 months （ranged 2-46 months） ,and no evidence of re- currence and metastasis. CONCLUSIONS： MCRCC, classified as a subtype of renal clear cell carcinoma,generally exhibits a low malignant potential and good prognosis. The nephron-sparing surgery or nephroectomy could be performed in manag- ing c

关 键 词：癌 肾细胞 外科学 回顾性研究 肾切除术 随访研究 预后 

分 类 号：R737.11[医药卫生—肿瘤]