不同亚型的囊性肾癌诊疗与预后分析  

Clinical analysis of the different subtypes of cystic renal cell carcinoma:a report of 75 cases

作　　者：邓晓敬 王宇航[1] 刘春雨[1] 

机构地区：[1]天津医科大学第二医院泌尿外科,天津300211

出　　处：《天津医科大学学报》2017年第3期256-258,273,共4页Journal of Tianjin Medical University

摘　　要：目的:探讨不同亚型的囊性肾癌的诊疗及预后情况。方法:回顾性分析75例囊性肾癌患者的临床资料。患者术前影像学检查:56例考虑恶性病变,13例考虑单纯性肾囊肿,6例考虑为多房性肾囊肿。47例行根治性肾切除术,其中开放手术20例,腹腔镜手术27例;保留肾单位手术14例,其中开放手术9例,腹腔镜手术5例;后腹腔镜下肾囊肿去顶减压术13例,其中2例术中冰冻病理检查提示恶性,同期行根治性肾切除术,9例术后2~3周二期行根治性肾切除术,2例密切随访;1例行保留肾单位手术,术中冰冻病理检查提示恶性病变,同期行根治性肾切除术。结果:75例术后病理报告均为囊性肾癌,其中肾细胞癌囊性变38例,多房囊性肾癌16例,单房囊性肾癌(囊腺癌)8例,肾囊肿恶变13例。随访25~147个月,平均63个月,未见肿瘤复发和转移。结论:囊性肾癌的诊疗及预后需根据不同的亚型分析,保留肾单位手术可作为囊性肾癌的一种可选择的治疗方式。Objective： To discuss the diagnosis and treatment of the different subtypes of cystic renal cell carciuoma（CRCC）.Methods： The clinical data of 75 cases with CRCC were analyzed retrospectively. Preoperative imaging procedures indicated that 56 cases were with malignant tumors,13 cases were with renal cyst and 6 cases had multilocular cyst of kidney. For treatment, Forty-seven patients received radical nephrectomy（laparoscopic radical nephrectom, n =20）, 14 patients received partial nephrectomy（laparoscopic partial nephrectom, n =5）and 13 patients received retroperitoneal laparoscopic cyst unroofed. Malignant tumors were detected by pathological analysis then 11 of them received supplementary nephrectomy, whereas 2 patients underwent active surveillace. One patient received partial nephrectomy and the pathological result showed malignant tumor and suggested radical nephrectomy. Results：The diagnosis of CRCC was confirmed by postoperative pathology. Histopathologic examination demonstrated muhilocular cystic renal cell carcinoma in 16 cases,unilocular cystic renal cell carcinoma in 8 cases,cystic necrosis of renal cell carcinoma in 34 cases and preexisting simple cyst eancerization in 13 cases.There were no loeal recurrence or metastases during follow up. Conclusion：Treating CRCC and assessing its prognosis could rely on its subtypes, and partial nephrectomy may be an effective invasive modality for treating CRCC.

关 键 词：囊性肾癌 亚型 肾癌囊性变 保留肾单位手术 

分 类 号：R737.11[医药卫生—肿瘤]