摘要
目的:探讨囊性肾癌(CRCC)的诊断及治疗方法。方法:回顾性分析18例CRCC患者的临床表现、影像学特征、手术方法、病理特征及随访结果。结果:18例患者术后病理均证实为CRCC,66.7%(12例)的病例行根治性肾脏切除术,33.3%(6例)行肾部分切除术。肿瘤最大直径为2.3～9.7 cm,平均4.2 cm。TNM分期为T1N0M0期12例,T2N0M0期6例。其中多房囊性肾癌7例,单房囊性肾癌4例,肾癌囊性坏死5例,单纯囊肿恶性变2例。随访12～84个月,平均40个月,均无复发和转移。结论:CRCC恶性度低,主要依靠影像学诊断,如术前诊断不明,术中须做冰冻病理来决定手术方式,保留肾单位的手术为治疗的最佳选择,囊性肾癌预后较好。
Objective： To investigate the diagnosis and treatment of cystic renal cell carcinoma（CRCC）. Methods：The clinical data of 18 cases with CRCC was analyzed retrospectively. The clinical presentation, radiologic features, surgical procedure, pathologic features as well as follow-up outcomes of the CRCC were studied. Results： The diagnosis of CRCC was confirmed by postoperative pathology. For treatment, radical nephrectomy was employed in 66.7% （12 cases） and partial nephreetomy in 33.3% （6 cases）. The diameter of the tumor ranges from 2.3 cm to 9.7 cm, with an average of 4.2 cm. 12 cases were classified as T1N0M0 and 6 cases as T2N0M0 for TNM staging. Histopathologic examination demonstrated multilocular cystic renal cell carcinoma in 7 cases, unilocular cystic renal cell carcinoma in 4 cases, renal cell carcinoma degeneration in 5 cases and preexisting simple cyst cancerization in 2 cases. All the patients remained tumor- free during a 12- to 84-month （40 months for average） follow-up. Conclusion： The preoperative diagnosis of CRCC is mainly dependant on imaging examination. Rapid frozen section analysis contributes to the pathological diagnosis and helps in determining the surgical methods. Nephron sparing surgery is the optimum choice. The patients with CRCC show relatively good prognosis.
出处
《天津医科大学学报》
2013年第1期65-66,69,共3页
Journal of Tianjin Medical University
关键词
囊性肾癌
肾囊肿
根治性肾切除术
cystic renal cell carcinoma
renal cyst
radical nephrectomy
