中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2013年
11期
819-822
,共4页
乳头状肾细胞癌%肾透明细胞癌%临床特点%病理学,临床%治疗
乳頭狀腎細胞癌%腎透明細胞癌%臨床特點%病理學,臨床%治療
유두상신세포암%신투명세포암%림상특점%병이학,림상%치료
Papillary renal cell carcinoma%Clear cell renal cell carcinoma%Clinical features%Pathology,clinical%Therapy
目的 探讨乳头状肾细胞癌的临床及病理学特点,以提高对其认识和诊治水平.方法 回顾性分析我院2007年1月至2012年1月收治的25例乳头状肾细胞癌患者的临床病理资料,占同期收治肾癌的3.03％.男17例,女8例.年龄24～76岁,平均54岁.肿瘤直径1.5 ～ 9.0 cm,平均4.5 cm.临床分期Ⅰ期16例,Ⅱ期5例,Ⅲ期4例.并与随机抽取的同期100例肾透明细胞癌的影像学资料作对比. 结果 乳头状肾细胞癌皮髓期、实质期及排泄期的CT值显著低于肾透明细胞癌,不均匀强化明显少于肾透明细胞癌,差异均有统计学意义(P＜0.05).25例乳头状肾细胞癌患者均接受手术治疗,行根治性肾切除术21例,保留肾单位手术4例.术后病理分期为pT1N0M016例,pT2N0M05例,pT3aN0M02例,pT1N1M01例,pT2N1M01例.病理分型:Ⅰ型8例,Ⅱ型17例.25例随访6～60个月,1例死于肿瘤转移,1例死于脑血管疾病,其余23例均无瘤生存. 结论 乳头状肾细胞癌是一种发病率较低、预后较好的特殊类型肾细胞癌,术前可依据影像学检查与肾透明细胞癌鉴别诊断,手术治疗效果较好,术后全身辅助治疗有待研究.
目的 探討乳頭狀腎細胞癌的臨床及病理學特點,以提高對其認識和診治水平.方法 迴顧性分析我院2007年1月至2012年1月收治的25例乳頭狀腎細胞癌患者的臨床病理資料,佔同期收治腎癌的3.03％.男17例,女8例.年齡24～76歲,平均54歲.腫瘤直徑1.5 ～ 9.0 cm,平均4.5 cm.臨床分期Ⅰ期16例,Ⅱ期5例,Ⅲ期4例.併與隨機抽取的同期100例腎透明細胞癌的影像學資料作對比. 結果 乳頭狀腎細胞癌皮髓期、實質期及排洩期的CT值顯著低于腎透明細胞癌,不均勻彊化明顯少于腎透明細胞癌,差異均有統計學意義(P＜0.05).25例乳頭狀腎細胞癌患者均接受手術治療,行根治性腎切除術21例,保留腎單位手術4例.術後病理分期為pT1N0M016例,pT2N0M05例,pT3aN0M02例,pT1N1M01例,pT2N1M01例.病理分型:Ⅰ型8例,Ⅱ型17例.25例隨訪6～60箇月,1例死于腫瘤轉移,1例死于腦血管疾病,其餘23例均無瘤生存. 結論 乳頭狀腎細胞癌是一種髮病率較低、預後較好的特殊類型腎細胞癌,術前可依據影像學檢查與腎透明細胞癌鑒彆診斷,手術治療效果較好,術後全身輔助治療有待研究.
목적 탐토유두상신세포암적림상급병이학특점,이제고대기인식화진치수평.방법 회고성분석아원2007년1월지2012년1월수치적25례유두상신세포암환자적림상병리자료,점동기수치신암적3.03％.남17례,녀8례.년령24～76세,평균54세.종류직경1.5 ～ 9.0 cm,평균4.5 cm.림상분기Ⅰ기16례,Ⅱ기5례,Ⅲ기4례.병여수궤추취적동기100례신투명세포암적영상학자료작대비. 결과 유두상신세포암피수기、실질기급배설기적CT치현저저우신투명세포암,불균균강화명현소우신투명세포암,차이균유통계학의의(P＜0.05).25례유두상신세포암환자균접수수술치료,행근치성신절제술21례,보류신단위수술4례.술후병리분기위pT1N0M016례,pT2N0M05례,pT3aN0M02례,pT1N1M01례,pT2N1M01례.병리분형:Ⅰ형8례,Ⅱ형17례.25례수방6～60개월,1례사우종류전이,1례사우뇌혈관질병,기여23례균무류생존. 결론 유두상신세포암시일충발병솔교저、예후교호적특수류형신세포암,술전가의거영상학검사여신투명세포암감별진단,수술치료효과교호,술후전신보조치료유대연구.
Objective To discuss the clinical manifestation and pathology of papillary renal cell carcinoma (PRCC).Methods From January 2007 to January 2012,the clinical and pathologic data of 25 patients (17 males and 8 females with average age of 54 years ranging from 24-76 years) with PRCC were retrospectively analyzed in combination with review of literature.The clinical stages of the tumor were as follows,Ⅰ in 16 cases,Ⅱ in 5 cases,Ⅲ in 4 cases.And the radiographic inspections of PRCC were compared with that of 100 randomly selected clear renal cell carcinoma (CRCC).Results All the PRCC cases had different imaging presentations compared with CRCC.CT attenuation of CRCC was higher than that of PRCC in corticomedullary,nephrographic and excretory phase (P＜0.05).Heterogeneous enhancement was most commonly seen in CRCC than PRCC (P＜0.05).There were 21 patients underwent radical nephrectomy,and 4 patients underwent laparoscopic nephron sparing surgery.The pTNM stages of the tumor were as follows,pT1N0M0 in 16 cases,pT2N0M0 in 5 cases,pT3aN0M0 in 2 cases,pT1N1M0 in 1 case,,pT2N1M0 in 1 case.Of these 25 patients,8 (32％) and 17 (68％) were diagnosed as type Ⅰ and type Ⅱ PRCC,respectively.All the 25 cases of patients were followed up from 6 to 60 months.One case died of metastasis,1 case died of cerebrovascular disease and the other 23 patients survived with tumor-free.Conclusions PRCC is a special type of RCC with low morbidity.Radiological examination can be used in the differential diagnosis of CRCC and PRCC before surgery.The prognosis after surgical treatment is good,but the adjuvant systemic treatment is to be study.
