肾集合管癌10例临床及病理特征研究  

Clinical and pathological features of renal collecting duct carcinoma:a study of 10 cases

作　　者：乔娟 王美玲 王弦[1] 秦蓉[1] 冯振中 吴继锋 QIAO Juan;WANG Meiling;WANG Xian;QIN Rong;FENG Zhenzhong;WU Jifeng(Department of Pathology,The Second Hospital of Anhui Medical University,Hefei,Anhui 230601,China)

机构地区：[1]安徽医科大学第二附属医院病理科,安徽合肥230601

出　　处：《现代医药卫生》2024年第3期395-399,共5页Journal of Modern Medicine & Health

摘　　要：目的 探讨肾集合管癌(CDC)的临床及病理特征。方法 选取2017年3月至2023年3月该院收治的10例CDC患者的临床、病理资料,对其进行随访及相关文献复习。结果 10例CDC患者临床症状无特异性,以血尿及腰部疼痛为主,部分伴尿频尿急、夜尿增多;肿瘤位于左、右侧肾各5例;10例均行肾脏根治性切除术。组织学上,肿瘤浸润性生长,肿瘤细胞呈管状、乳头状、巢团状或实性片状排列,或肉瘤样排列,管腔内部分肿瘤细胞呈靴钉样凸向腺腔;肿瘤细胞具有高级别核,细胞异型明显,核大,核仁明显,核分裂象易见;间质纤维组织增生明显伴较多炎细胞浸润;多数病例中见肿瘤坏死。免疫组化结果CK、CK7、CK19、Pax-8阳性,Vimentin、EMA、34βE12、CarbonicAⅨ不同程度阳性,RCC、CD10、CD117、TFE3、TFEB、P504S、CK20均阴性;Ki-67增殖指数20%~70%。7例获得随访,3例失访;截至随访日期,仅1例存活,6例均于2年内死亡。结论 CDC是一种非常少见的肾上皮恶性肿瘤,恶性程度高,病程进展快,预后差。Objective To investigate the clinical and pathological features of renal collecting duct carcinoma(CDC).Methods Clinical and pathological data of the 10 CDC patients diagnosed from 2017 to 2023 in this hospital were collected,followed up and relevant literatures were reviewed.Results The clinical symptoms of the 10 CDC patients were non-specific,mainly hematuria and lower back pain,and some were accompanied by frequent urination,urgency,and increased nocturia;The tumors of five cases were located in the left kidney and the others were located in the right kidney;All the 10 cases underwent radical nephrectomy.Histologically,the tumor underwent infiltrative growth,with tumor cells arranged in tubular,papillary,nested,or solid patches,or in a sarcomatoid manner.Some tumor cells within the lumen protruded into the glandular cavity in a shoe like manner;Tumor cells had high-grade differentiated nuclei,obvious cell abnormalities,large nuclei,prominent nucleoli,and mitotic figures were easily visible;Interstitial fibrous tissue hyperplasia was with significant infiltration of inflammatory cells;Tumor necrosis was seen in most cases.Immunohistochemical results showed positive expression of CK,CK7,CK19,Pax-8,and Vimentin,EMA,34βE12 and Carbonica IX were positive to varying degrees,while RCC,CD10,CD117,TFE3,TFEB,P504S,and CK20 were all negative;The proliferation index of Ki-67 was 20%-70%.Seven cases were followed up,and three cases were lost;At the date of the last follow-up,only one case survived,and six cases all died within two years.Conclusion CDC is a very rare renal epithelial malignancy with high malignancy,rapid progression,and poor prognosis.

关 键 词：肾 集合管癌 组织学 免疫组化 鉴别诊断 

分 类 号：R737.11[医药卫生—肿瘤]