CAJ | 학술논문

目的分析3例民航飞行员小肾癌病例并进行文献复习,以期加强对该病的认识,提高诊断和鉴定水平. 方法介绍3例民航飞行员小肾癌的临床资料,分析并探讨该病的诊断和医学鉴定方法. 结果 3例患者肿瘤大小均<3 cm,术前明确诊断1例,倾向于恶性和良性各1例,1例行腹腔镜肾脏部分切除术,两例行肾癌根治术,病理检查均诊断为肾透明细胞癌(高分化),肿瘤分期均为T1aN0M0,随访1～6.5年,未见复发.3例明确诊断后即鉴定为飞行不合格,其中1例病程长者于术后第2年特许飞行合格至今,飞行良好. 结论小肾癌诊断较困难,应综合多种影像学检查以明确,确诊仍是病理诊断.小肾癌分期早,分化高,预后好,发生突然失能的可能性低.排除复发或转移,3个月后即可评定为飞行合格,需密切随访.
목적 분석3례민항비행원소신암병례병진행문헌복습,이기가강대해병적인식,제고진단화감정수평. 방법개소3례민항비행원소신암적림상자료,분석병탐토해병적진단화의학감정방법. 결과 3례환자종류대소균<3 cm,술전명학진단1례,경향우악성화량성각1례,1례행복강경신장부분절제술,량례행신암근치술,병리검사균진단위신투명세포암(고분화),종류분기균위T1aN0M0,수방1～6.5년,미견복발.3례명학진단후즉감정위비행불합격,기중1례병정장자우술후제2년특허비행합격지금,비행량호. 결론소신암진단교곤난,응종합다충영상학검사이명학,학진잉시병리진단.소신암분기조,분화고,예후호,발생돌연실능적가능성저.배제복발혹전이,3개월후즉가평정위비행합격,수밀절수방.
Objective Small renal cell carcinoma cases of 3 civil pilots were analyzed retrospectively and correlative literatures were reviewed, in order to strengthen the understanding of the disease and improve the level of diagnosis and assessment of it. Methods Clinical data of small renal cell carcinoma cases of 3 civil pilots were introduced. Diagnosis and medical assessment methods of the disease were analyzed and discussed. Results The tumor size of 3 cases was less than 3 cm,of which 1 case was identified before surgery, 1 case was inclined to be benign and the other was inclined to be malignant. One case underwent laparoscopic partial nephrectomy and the other 2 cases underwent radical nephrectomy. The pathologic diagnosis was renal clear-cell carcinoma (well-differentiated), and the tumor staging was T1aN0M0. Following-up time was 1～6.5 years without relapse. They were assessed as flying disqualification after final diagnosis. One pilot with longer course of the disease was identified qualification specially the second year after surgery and with good flight till now. Conclusion The diagnosis of small renal cell carcinoma is difficult and should be depended on multitude imaging examinations. The final diagnosis is pathology. Small renal cell carcinoma has early stage, well differentiation and good prognosis. The probability of sudden disability is very low. The disease without relapse or metastasis can be assessed as flying qualification 3 months after surgery with close follow-up.