12例肾集合管癌临床病理分析  

Analysis of clinicopathological features in 12 patients with collecting duct carcinoma of the kidney

作　　者：王艳青[1] 黄吉炜[1] 潘家骅[1] 张进[1] 董柏君[1] 陈勇辉[1] 薛蔚[1] 黄翼然[1] 

机构地区：[1]上海交通大学医学院附属仁济医院泌尿外科,上海200127

出　　处：《临床泌尿外科杂志》2014年第10期867-870,共4页Journal of Clinical Urology

基　　金：国家自然科学基金(编号81272841);上海市自然科学基金(编号13ZR1425100);上海市医学领先专业重点学科基金(编号2013SY027)

摘　　要：目的：研究肾集合管癌的临床病理特征。方法：回顾性分析12例肾集合管癌的临床、病理及预后资料,男8例,女4例,平均58.1（33-77）岁,血尿3例,腰痛3例,血尿伴腰痛2例,CT增强检测呈少血供特征。结果：12例均行根治性肾切除术。肿瘤平均最大径7.1（2.2-15.0）cm,3例淋巴转移,2例远处转移。肿瘤镜下表现为腺管状或腺管乳头状,常伴坏死,部分混有肉瘤样变。患者术后平均随访时间为25.6（3.2-68.0）个月,中位生存时间为31.1个月,1例失访,6例因肿瘤死亡,5例无瘤生存。结论：肾集合管癌是一种罕见的肾细胞癌,就诊时多有症状,影像学仅起提示作用,病理是唯一确诊手段。手术切除是治疗肾集合管癌的主要方法,靶向治疗可能是术后辅助治疗转移性肾集合管癌的有效方案。肿瘤恶性程度高,进展迅速,转移早,总体预后不良。Objective：To analyze the clinical and pathological features of collecting duct carcinoma（CDC）of the kidney.Method：Twelve patients with CDC of the kidney treated in our hospital included eight males and four females whose mean age was 58.1（range,33-77）years.Their clinical,pathological,and survival data were retrospectively recorded and analyzed.Three of them presented hematuria and another three cases experienced flank pain.The CT scan showed poor blood supply to the lesion in kidney.Result：Radical nephrectomy was performed in 12 cases.Under microscope,the tumor mainly presented irregular tubular or tubulopapillary growth pattern,always with necrosis,a few with sarcomatoid tissues.The mean maximum diameter of tumor was 7.1（range,2.2-15.0）cm.Pathological data also indicated lymphatic metastases were found in three cases and distant metastases were seen in two patients.The mean postoperative follow-up period was 25.6（range,3.2-68.0）months,and the median survival time was 31.1months.The follow-up outcome showed six patients died of CDC of the kidney or metastasis,five patients survived with tumor free,and one patient didn＇t follow up.Conclusion：CDC of the kidney is a rare histological type of renal cell carcinoma.The patients with CDC of the kidney always have discomfort.The results of CT may be suggestive,but the final diagnosis depends on histopathological examination.The main therapeutic method is radical nephrectomy,and the targeted medicines may be suitable for the metastastic CDC of the kidney after operation.CDC of the kidney has poor prognosis because of its high degree of malignancy,rapid progression and early metastasis.

关 键 词：肾集合管癌 肾肿瘤 预后 

分 类 号：R737.11[医药卫生—肿瘤]