CAJ | 학술논문

目的：：分析总结肾嫌色细胞癌的临床特点,提高其临床诊治水平.方法：回顾性分析2010年1月~2013年7月期间收治的76例病理诊断为肾嫌色细胞癌患者的临床及病理资料.其中男40例,女36例,年龄22~71岁,平均49岁.病变位于左侧37例,右侧39例.结果：76例均行手术治疗,其中根治性肾切除术47例,保留肾单位手术29例.73例行腹腔镜手术,3例行开放手术治疗,两组手术时间差异无统计学意义,但腹腔镜组平均术中出血量明显低于开放手术组.肿瘤最大径为1~11 cm,平均4.6 cm.病理分期：64例 pT1 N0 M0,10例 pT2 N0 M0,1例 pT3 N0 M0,1例pT1 N0 M1.Fuhrman分级：Ⅰ级50例,Ⅱ级16例,Ⅲ级6例,Ⅳ级4例.术后76例均获得随访,随访时间15~58个月,平均(33.8±12.0)个月,未出现复发或因肿瘤导致死亡者.结论：肾嫌色细胞癌是肾细胞癌的一种少见类型,手术切除是目前首选的治疗方式,腹腔镜手术与开放手术治疗效果相似,微创优势显著.本病较少复发和转移,预后良好.
목적：：분석총결신혐색세포암적림상특점,제고기림상진치수평.방법：회고성분석2010년1월~2013년7월기간수치적76례병리진단위신혐색세포암환자적림상급병리자료.기중남40례,녀36례,년령22~71세,평균49세.병변위우좌측37례,우측39례.결과：76례균행수술치료,기중근치성신절제술47례,보류신단위수술29례.73례행복강경수술,3례행개방수술치료,량조수술시간차이무통계학의의,단복강경조평균술중출혈량명현저우개방수술조.종류최대경위1~11 cm,평균4.6 cm.병리분기：64례 pT1 N0 M0,10례 pT2 N0 M0,1례 pT3 N0 M0,1례pT1 N0 M1.Fuhrman분급：Ⅰ급50례,Ⅱ급16례,Ⅲ급6례,Ⅳ급4례.술후76례균획득수방,수방시간15~58개월,평균(33.8±12.0)개월,미출현복발혹인종류도치사망자.결론：신혐색세포암시신세포암적일충소견류형,수술절제시목전수선적치료방식,복강경수술여개방수술치료효과상사,미창우세현저.본병교소복발화전이,예후량호.
Objective:To improve the diagnosis and treatment of chromophobe renal cell carcinoma (CRCC),we investigated the clinical features of CRCC patients in our hospital.Methods:We retrospectively reviewed the clinico-pathologic data of 76 patients with CRCC seen in our hospital from January 2010 to July 2013.The mean age of these patients at diagnosis was 49 years-old,including 40 males and 36 females.All tumors were localized unilaterally, with 37 in left kidney and 39 in right kidney.Results:All of the 76 patients successfully received nephrectomy.Forty-seven patients underwent radical nephrectomy,29 patients received nephron sparing surgery.Seventy-three patients were treated with laparoscopic surgery and 3 were treated with open surgery,with the similar mean operative time. The mean operative blood loss was significantly less in laparoscopic surgery group.The average maximum diameter of tumors was 4.6 cm.Among them,64 patients were at pT1 N0 M0 ,10 at pT2 N0 M0 ,1 at pT3 N0 M0 and 1 at pT1 N0 M1 .The pathologic Fuhrman grade of CRCC was G1 in 50 cases,G2 in 16 cases,G3 in 6 cases,G4 in 4 cases. All patients were followed up with a mean duration of 33.8 months and no local recurrence was found.Conclusions:CRCC is a rare subtype of renal cell carcinoma with infrequent recurrence and metastasis.Surgery is the standard treatment for CRCC.The laparoscopic surgery has similar treatment efficacy to open surgery,but deserves signifi-cant micro-invasive advantages.CRCC patients have favorable prognosis.