多房囊性肾细胞癌的临床病理特点及预后分析  

Clinical and pathological feature and prognosis for multilocular cystic renal cell carcinoma

作　　者：曹达龙[1] 戴波[1] 张海梁[1] 沈益君[1] 朱耀[1] 朱一平[1] 施国海[1] 马春光[1] 肖文军[1] 秦晓健[1] 林国文[1] 叶定伟[1] 

机构地区：[1]复旦大学附属肿瘤医院泌尿外科复旦大学上海医学院肿瘤学系,上海200032

出　　处：《中华泌尿外科杂志》2015年第3期188-191,共4页Chinese Journal of Urology

基　　金：国家自然科学基金（81302213,81272837）;复旦大学附属肿瘤医院院级基金（YJ201206）

摘　　要：目的 探讨多房囊性肾细胞癌的临床病理特点及其预后. 方法 回顾性分析2002年1月至2012年12月收治的27例多房囊性肾细胞癌患者的临床资料.男19例,年龄32-67岁,平均52岁;女8例,年龄48 - 66岁,平均56岁.27例均无特殊临床表现.CT检查示肾多囊性肿块,囊壁或分隔强化明显;Bosniak分级：Ⅲ级21例,Ⅳ级6例.MRI检查表现为长T1、长T2信号影,增强扫描见明显分隔样强化.肿瘤位于左肾10例,右肾16例,双肾1例.肿瘤最大径1.0-8.0 cm,平均4.4 cm.全麻下行根治性肾切除术11例,肾部分切除术16例. 结果 27例术后病理诊断均为多房囊性肾细胞癌,肿瘤分期：T1aN0M0期19例,T1bN0M0期6例,T2N0M0期2例.其中,18例表达CD10、17例表达波形蛋白（Vimentin）、27例表达上皮膜抗原（EMA）和20例表达CK7,均不表达CD68.术后随访5- 145个月,均未见复发和转移,无肿瘤相关的死亡病例. 结论 多房囊性肾细胞癌是肾癌的一种特殊类型,病理分期早、预后良好,若诊断明确,应及时手术治疗.Objective To investigate the clinicopathological features of multilocular cystic renal cell carcinoma （MCRCC）.Methods The clinicopathological data of 27 patients with MCRCC diagnosed and treated in Fudan University Shanghai Cancer Center from 2002 to 2012 were retrospectively analyzed.There were 19 males and 8 females with non-specific clinical manifestation.CT scan showed a polycystic mass with enhanced cystic wall and septum in enhancement scanning.Of which,21 cases of Bosniak Ⅲ and 6 cases of Bosniak Ⅳ.MRI revealed a mass with long T1 and T2 signal with clearly separated-liked enhanced mass in enhancement scan.Ten cases of tumor located in the left renal,16 cases in the right renal,1 case in the double kidney.The mean of tumor diameter was 4.4 （1.0-8.0） cm.Eleven patients underwent radical nephrectomy while the other 16 cases received nephron sparing surgery.Results The pathological staging showed pT1aN0M0 in 19 cases,pT1bN0M0 in 6 cases,and pT2N0M02 cases.In immunohistochemical study,tumor cells from 18 cases were positive for CD10,17 positive for vimentin,27 positive for EMA,20 positive for CK7,while all negative for CD68.During 5-145 months of follow-up,none of patients showed any evidence of recurrence and metastasis,with non-tumor-related mortality.Conclusions MCRCC as a rare type of kidney cancer has low pathological stage and good prognosis,and should be treated with surgery if the diagnosis of MCRCC is suspected and confirmed.

关 键 词：多房囊性肾细胞癌 临床病理特点 预后 

分 类 号：R737.11[医药卫生—肿瘤]