CAJ | 학술논문

目的探讨获得性肾囊性疾病(ACKD)合并肾癌的诊断治疗策略.方法回顾性分析11例终末期肾衰竭、获得性肾囊肿合并肾癌患者的临床资料.男8例,女3例.平均年龄55(37～68)岁.行血液透析至发现肾脏病变时间平均为4.8(2.8～7.4)年.结果 11例均行肾癌根治术.术后病理报告:透明细胞癌3例,乳头状癌6例,嫌色细胞癌1例,乳头状腺瘤1例.病理分期T1a9例,T1b 2例.11例术后随访平均55(17～83)个月.1例术后24个月发现肺转移;1例单侧发病者术后22个月对侧复发,行肾癌根治术;1例死于心血管疾病;1例随访19个月后失访;无瘤生存7例.结论 ACKD与肾癌有较高的相关性.终末期肾衰竭患者透析前氮质血症时间较长或透析时间＞3年者,应排除ACKD.超声及CT检查对早期诊断存在价值.除关注ACKD恶性变倾向外,对长期肾衰竭患者的其他并发症如心脑血管疾病、糖尿病等也应足够重视并行积极治疗.
목적 탐토획득성신낭성질병(ACKD)합병신암적진단치료책략.방법 회고성분석11례종말기신쇠갈、획득성신낭종합병신암환자적림상자료.남8례,녀3례.평균년령55(37～68)세.행혈액투석지발현신장병변시간평균위4.8(2.8～7.4)년.결과 11례균행신암근치술.술후병리보고:투명세포암3례,유두상암6례,혐색세포암1례,유두상선류1례.병리분기T1a9례,T1b 2례.11례술후수방평균55(17～83)개월.1례술후24개월발현폐전이;1례단측발병자술후22개월대측복발,행신암근치술;1례사우심혈관질병;1례수방19개월후실방;무류생존7례.결론 ACKD여신암유교고적상관성.종말기신쇠갈환자투석전담질혈증시간교장혹투석시간＞3년자,응배제ACKD.초성급CT검사대조기진단존재개치.제관주ACKD악성변경향외,대장기신쇠갈환자적기타병발증여심뇌혈관질병、당뇨병등야응족구중시병행적겁치료.
Objective To discuss the diagnosis and treatment of acquired cystic kidney disease complicated by kidney cancer. Methods Clinical data of 11 patients with acquired cystic kidney disease complicated by kidney cancer were analyzed retrospectively. Eight patients were male and three were female. The mean age was 55 years old (range 37 to 68). The time of hemodialysis ranged from 2.8 to 7. 4 years, mean 4. 8 years. Results Follow-up ranged from 17- 83 months, mean 55 months. One patient died of cardiovascular disease. Lung metastasis was detected in one patient two years after surgery. Seven patients survived free of tumor recurrence and there was no follow-up on one patient. Conclusions Increased incidence of cancer was observed in patients with end-stage renal disease who have undergone long-term dialysis. In particular, renal cell carcinoma (RCC) showed an excess incidence in ACKD patients. RCC showed an increased prevalence compared with the general population. Patients with predialysis azotemia or a dialysis duration of longer than 3 years should be screened for ACKD. Sonegraphy or CT scanning are useful for early diagnosis of ACKD. We should pay close attention to complications, including ACKD malignant tendency, in patients who have been taking long-term dialysis and positive therapy.