囊性肾癌5例报告并文献复习  

Diagnosis and treatment of cystic renal cell carcinoma:report of five cases and literature review

作　　者：邓刚[1,2] 居翔 孟琦[1,2] 马立彬[1,2] 于志坚[1,2] 

机构地区：[1]南京医科大学附属杭州医院 [2]杭州市第一人民医院泌尿外科,杭州310006

出　　处：《临床泌尿外科杂志》2014年第5期402-404,共3页Journal of Clinical Urology

基　　金：浙江省自然科学基金项目(编号Y2111329);浙江省医药卫生科技计划项目(编号2011KYB066);浙江省中医药卫生科技计划项目(编号2011ZB099);杭州市医疗卫生科研项目计划项目(编号20110833B05);浙江省医学会临床科研资金项目(编号2012ZYC-A35)

摘　　要：目的：探讨囊性肾癌的早期诊断及治疗方法。方法：回顾性分析2008年1月～2012年8月间收治的5例囊性肾癌患者的临床资料，1例术前影像学检查提示双侧肾脏占位病变，一侧为囊性占位病变；4例显示单侧肾脏单发囊性占位病变，左肾3例，右肾1例；其中男3例，女2例；年龄46～68岁，平均56．4岁；肿瘤体积21．84～208ml，平均101．96ml。按照Bosniak分类，Ⅱ类1例，Ⅲ类2例，Ⅳ类2例；T1期2例，T2期2例，T3期1例。3例术前诊断为囊性肾癌，1例为肾脏囊肿，1例为肾嗜酸性细胞瘤合并囊性肾癌。2例行肾癌根治术，2例行肾部分切除术，1例行囊肿去顶减压术后2周行肾癌根治术。并结合相关文献复习进行分析讨论。结果：5例患者术后病理检查报告证实为透明细胞癌2例，乳头状细胞癌1例，多房囊性肾癌1例，嗜酸细胞腺瘤伴囊性变1例。平均随访34．4个月（10～66个月），1例发生骨骼及肺部转移，余4例均无复发转移。结论：囊性肾癌是一种广义上的。肾癌分类，有四种分型；与其他类型肾癌相比，大部分恶性程度较低。囊性。肾癌的术前诊断主要依赖于影像学检查，对于可疑病例，术中需行快速冷冻病理检查。对此类肿瘤，建议行保留肾单位手术。Objective： To explore the clinical features, early diagnosis, treatment methods and prognosis of cystic renal cell carcinoma （CRCC）. Method： The data of five cases of cystic renal cell carcinoma were reviewed and analyzed combined with related literature from January 2008 to August 2012. Preoperative imaging revealed bilateral kidneys with single tumor could be seen in one case and unilateral kidney with single tumor could be seen in four cases including three cases of left kidney and one case of right kidney. Enrolled five cases included three males and two females aging from 46 to 68 （mean, 56.4） years and tumor size was from 21.84 to 208 （mean, 101.96） ml. According to Bosniak classification, there was one case in category Ⅱ , two cases in category Ⅲ and two cases in category Ⅳ. According to TNM staging system, there were two cases in T1, two cases in T2 and one case in T3. Preoperative diagnosis of three cases were cystic renal cell carcinoma, one case was renal cyst and the rest one case was renal oncocytoma cell tumor with cystic renal cancer. Two cases underwent radical nephrectomy and another two cases were received partial nephrectomy. The rest one case was taken radical nephrectomy in two weeks after renal cyst unroofing. Result： Postoperative pathology of these five cases confirmed two cases were diagnosed as clear cell carcinoma, one case was diagnosed as papillary carcinoma, one case was diagnosed as multi- locular cystic renal cell carcinoma and one case was diagnosed as acidophilic cell adenoma with cystic changing. Mean follow-up period was 34.4 （range, 10-66） months. The data of follow-up showed that one case was found bone and lung metastasis after seven months and four cases were not seen any evidence of recurrence or metastasis. Conclusion：Cystic renal cell carcinoma is a kind of kidney cancer classification in general which has four types. Pre- operative diagnosis of cystic renal cell carcinoma mainly depends on imaging examination. Rapid intraoperative pathologi

关 键 词：肾肿瘤 癌 腺样囊肿 肾切除术 

分 类 号：R737.11[医药卫生—肿瘤]