囊性肾癌27例诊治分析  

Diagnosis and treatment of cystic renal cell carcinoma(Report of 27Cases)

作　　者：翟晓强[1] 雒启东[1] 张栋[1] 李建平[1] 赵军[1] 李和程[1] 种铁[1] 

机构地区：[1]西安交通大学第二附属医院泌尿外科,西安710004

出　　处：《临床泌尿外科杂志》2014年第7期587-588,592,共3页Journal of Clinical Urology

摘　　要：目的：探讨囊性肾癌（CRCC）的临床特点,提高其诊治水平。方法：回顾性分析27例CRCC患者的症状与体征、影像学表现、手术方式、病理检查及随访结果。结果：综合B超、CT、MRI、超声造影等检查诊断CRCC 24例,疑似肾癌2例,误诊为肾囊肿1例。行保留肾单位手术15例,根治性肾切除11例,肾囊肿去顶减压后再行根治性肾切除1例。病理检查报告为透明细胞癌26例,乳头状肾细胞癌1例;临床分期T1aN0M08例,T1bN0M012例,T2aN0M05例,T2bN0M02例;组织分级G16例,G221例。27例随访6～78个月,平均21个月,除1例术后3个月局部复发外,其余26例均无复发和转移。结论：综合多种影像学检查能提高CRCC的诊断率,部分患者保留肾单位手术能达到与根治性肾切除术同样的治疗效果。除肾癌囊性坏死型外,其余类型预后较好。Objective：To investigate the diagnosis and management of cystic renal cell carcinoma（CRCC）.Method：The clinical symptoms and signs,radiological features,surgical procedure,pathology,and follow-up outcomes of 27cases of CRCC were retrospectively analyzed.Result：Based on ultrasound,CT scan,MRI,and contrast-enhanced ultrasound,24cases were diagnosed with CRCC,two cases were suspected renal cancer,and one patient was misdiagnosed as renal cyst.Fifteen of them underwent nephron-sparing surgery,11of them underwent radical nephrectomy,and the rest one patient underwent unroofing of renal cyst followed by radical nephrectomy.The pathological report showed eight cases were classified as T1aN0M0,12cases as T1bN0M0,five cases as T2aN0M0,and two cases as T2bN0M0for TNM staging.Histopathologic examination demonstrated clear cell carcinoma in 26cases and papillary renal cell carcinoma in one case.All patients remained tumor-free during 6-78（average,21）months follow-up period except that one patient was found local recurrence three months postoperatively.Conclusion：Combination of multiple imaging examinations can improve the diagnosis of CRCC.Nephron-sparing surgery can achieve the same therapeutic effect as the radical nephrectomy in some patients.The patients with CRCC show relatively good prognosis except necrotic cystic renal cell carcinoma.

关 键 词：肾肿瘤 囊性肾癌 诊断 治疗 

分 类 号：R737.11[医药卫生—肿瘤]