CAJ | 학술논문

探讨保留肾单位手术治疗T1期肾细胞癌时肿瘤周围组织的安全切缘，并评价术中评价（IE）肿瘤切缘方法的效果。T 1期肾癌根治术标本50例，连续组织切片检查包膜完整性及多中心病灶。回顾21例肾部分切除术患者的临床病理资料，IE方法为切除肿瘤后从顶部到肿瘤基底部沿最长轴切开，肉眼观察。肿瘤直径和包膜完整性为多中心灶的显著相关因素（P＜0．05）。21例肾部分切除术患者切缘范围为1mm～10mm均阴性，随访12个月～118个月（平均35个月），均无瘤存活。IE评价术中切缘情况安全有效，对于IE观察假包膜完整者，切缘3mm～5mm即可，如观察假包膜不完整，切缘应达到5mm～10mm。
탐토보류신단위수술치료T1기신세포암시종류주위조직적안전절연，병평개술중평개（IE）종류절연방법적효과。T 1기신암근치술표본50례，련속조직절편검사포막완정성급다중심병조。회고21례신부분절제술환자적림상병리자료，IE방법위절제종류후종정부도종류기저부연최장축절개，육안관찰。종류직경화포막완정성위다중심조적현저상관인소（P＜0．05）。21례신부분절제술환자절연범위위1mm～10mm균음성，수방12개월～118개월（평균35개월），균무류존활。IE평개술중절연정황안전유효，대우IE관찰가포막완정자，절연3mm～5mm즉가，여관찰가포막불완정，절연응체도5mm～10mm。
To provide a basis for the safety excision margins in nephron sparing surgery for patients with T1 renal cell carcinoma .And to determine the efficacy of a new method called by us as"intra‐operative evaluation"for the assessment of surgical margin (SM) status .We retrospectively analyzed a total of 21 patients who had undergone partial nephrectomy (PN) for renal cell carcinoma .After the excision ,the tumors were uniformly divided into two halves for the evaluation of the safety of SMs .Findings of IE were compared with the permanent section analysis in terms of SM status .50 kidneys suffered from radical nephrectomy for RCC were examined for any tumor invasion of the pseudocapsule ,micro‐multifocal carcinoma beyond pseudocapsule . IE showed intact margins and none of the patients had positive SM in the final pathological examination .There was no evidence of local recurrence or distant metastasis with a mean follow‐up of 35 (12~118) months .All patients were alive .The total incidence of multifocal carcinoma in this group was 4 .0% .Tumor size and interrupted pseudocapsule were two significant predictors of multicentricity of RCC (P< 0 .05) .IE of resected specimen was a safe and effective method for the evaluation of SMs in partial nephrectomy patients .The proper surgical margin was 3mm~5mm in patients with complete pseudocapsule ,5mm~10mm in patients without complete pseudocapsule .