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摘要: 肉瘤样肾细胞癌(sarcomatoid renal cell carcinoma，SRCC)是一种特殊类型的肾癌，临床少见，恶性程度高，无特异性临床表现，缺乏生物标记物，传统治疗方式疗效不佳，预后极差，是临床上较难诊治的疾病。目前诊断仍首选CT检查，联合CT、MRI、PET/CT及穿刺病理活检等多种方式对于SRCC诊断及鉴别诊断具有重要临床意义。治疗上多采取以根治性肾切除术为主，辅以基于免疫治疗的全身治疗。随着SRCC分子机制研究的不断深入及临床试验的开展，免疫联合靶向治疗显示出广阔应用前景，但现有证据较少，且多数为小样本回顾性研究，存在局限性，仍需进一步前瞻性随机对照研究为SRCC的诊疗提供更高等级的循证医学证据。Abstract: Sarcomatoid renal cell carcinoma (SRCC) is a rare renal carcinoma of special type, with a high degree of malignancy and poor prognosis. Due to lacking special clinical manifestations and biomarkers, and poor efficacy of traditional therapy, it is difficult to diagnose and treat SRCC clinically. At present, CT examination remains the initial choice for diagnosing SRCC. The combination of CT, MRI, PET/CT and biopsy is of great clinical significance in the diagnosis and differential diagnosis of SRCC. Radical nephrectomy supplemented by immunotherapy-based systemic therapy remains the mainstay of treating SRCC. With the deepening research of molecular mechanism and the development of clinical trials in SRCC, immunotherapy in combination with targeted therapy shows a broad application prospect. However, the available evidence remains relatively few, and most studies were small sample retrospective design with limitations. Hence, further prospective randomized controlled studies are needed to provide higher levels of evidence-based medical basis for the diagnosis and treatment of SRCC.
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Key words:
- sarcomatoid renal cell carcinoma /
- diagnosis /
- targeted therapy /
- immunotherapy
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