CAJ | 학술논문

目的　探讨乳头状肾细胞癌的临床病理表现，提高对此类型肾癌的认识。　方法　回顾性分析9例乳头状肾细胞癌患者临床病理资料并进行随访　结果　9例乳头状肾细胞癌占同期肾癌的1.9%，平均发病年龄52岁。无自觉症状者5例，血尿4例。7例行肾癌根治术，1例行肾输尿管全长切除术，1例行保留肾单位的肿瘤切除术。肿瘤最大径4～15 cm，多位于肾皮质，淡黄色到金黄色，单灶或多灶性结节状生长。均以乳头或乳头管状结构为主，乳头轴心可见泡沫细胞。9例均有细胞角蛋白CK7表达。Fuhrman病理分级G1 3例、G2 4例、G3 2例。TNM病理分期pT2 7例、pT3a 1例、pT3bN1V1b 1例。随访7例无瘤生存36～134个月，1例G2 pT3b者无瘤生存11个月，1例G3 pT3a者13 个月后死于肾癌转移。　结论　乳头状肾细胞癌是少见的肾癌，表现为低分期，预后好。
목적　탐토유두상신세포암적림상병리표현， 제고대차류형신암적인식。　방법　회고성분석9례유두상신세포암 환자림상병리자료병진행수방　결과　9례유두상신세포암점동기신 암적1.9%，평균발병년령52세。무자각증상자5례，혈뇨4례。7례행신암근치술，1례행 신수뇨관전장절제술，1례행보류신단위적종류절제술。종류최대경4～15 cm，다위우신피 질，담황색도금황색，단조혹다조성결절상생장。균이유두혹유두관상결구위주，유두축심 가견포말세포。9례균유세포각단백CK7표체。Fuhrman병리분급G1 3례、G2 4례、G3 2례。TNM병리분기pT2 7례、pT3a 1례、pT3bN1V1b 1례。수방7례 무류생존36～134개월，1례G2 pT3b자무류생존11개월，1례G3 pT3a자13 개월후사우신암전이。　결론　유두상신세포암시소견적신암，표 현위저분기，예후호。
Objective　To study the clinical and patholo gical manifestations of papillary renal cell carcinoma(PRCC) and to improve the recognization of this subtype of renal cell carcinoma(RCC).　Metho ds　A retrospective study was done including revewing the clinical do cuments and the pathological sections of 9 cases of PRCC.Follow-up was made in all cases.　Results　466 cases of RCC were encountered in our institute between January 1989 and June 30,1999. 9 (1.9%) cases of PRCC were identified.The patients were seven men and two women whose age ranged from 33 to 69 years(mean age 52 years).Four presented with gross hematuria and 5 without any symptom being detected on ultrasound exam in a routine physical examination .Radical nephrectomy was done in 7 patients,resection of kidney and whole ureter was done in one patient,nephron-sparing surgery was done in one patient.The tu mor ranged from 4 to 15 cm in the greatest dimension.Most tumors located in the cortex of kidney with straw yellow or golden yellow appearance.Multifocality was found in five cases.Microscopically,PRCCs were predominantly papillary or tubul opapillary,often with a thick fibrous capsule and foam cells.Cytokeratin 7 was e xpressed in all cases.The Fuhrman's nuclear grade of the PRCC was grade 1 in 3 c ases,grade 2 in 4 and grade 3 in 2.The TNM stage was pT2 in 7 cases,pT3a in one and pT3bN1V1b in one.Seven patients were alive and tumor f ree for 36 months to 134 months with a mean of 85.4 months.One with G3 pT3 b has been alive and tumor free for 11 months.One with G3 pT3a died of metastasis.　Conclusions　PRCC is an uncommon subtype of RCC in China,it tends to present at an earlier stage and ha s a better prognosis.