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摘要: 肾细胞癌(renal cell carcinoma,RCC)是一种常见的泌尿系恶性肿瘤,随着早期肾细胞癌诊断率的不断提升,保留肾单位手术(nephron-sparing surgery,NSS)成为治疗T1期和部分T2期肾细胞癌的金标准,以肾部分切除术(partial nephrectomy,PN)应用广泛,但是该手术方式以及术后并发症存在一定的风险,因此术后评估肾功能对于评价手术安全性以及预测患者预后至关重要。本文介绍了近年来PN术后肾功能评估方法的研究进展。Abstract: Renal cell carcinoma (RCC) is a common urological malignancy. With the increasing diagnostic yield of early-stage RCC, nephron-sparing surgery (NSS) has become gold standard for the treatment of stage T1 and partial T2 RCC, and partial nephrectomy (PN) is widely used. However, there are certain risks associated with the surgical modality as well as postoperative complications, so postoperative evaluation of renal function is essential to assess surgical safety and to predict patient outcomes. This article describes recent advances in methods for the assessment of renal function after PN.
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[1] Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6): 394-424. doi: 10.3322/caac.21492
[2] Ljungberg B, Albiges L, Abu-Ghanem Y, et al. European Association of Urology Guidelines on Renal Cell Carcinoma: The 2019 Update[J]. Eur Urol, 2019, 75(5): 799-810. doi: 10.1016/j.eururo.2019.02.011
[3] 中国医促会泌尿健康促进分会, 中国研究型医院学会泌尿外科学专业委员会. 肾部分切除术安全共识[J]. 现代泌尿外科杂志, 2020, 25(6): 474-481, 500. doi: 10.3969/j.issn.1009-8291.2020.06.003
[4] 李强, 李铁军, 刘亮程, 等. 机器人辅助腹腔镜下阻断与不阻断肾血管肾部分切除术比较的系统评价和Meta分析[J]. 临床泌尿外科杂志, 2020, 35(9): 709-715. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMW202009009.htm
[5] 古志明. 三种评估活体供肾者肾小球滤过率方法的对比研究[J]. 医学综述, 2014, 20(5): 956-958. doi: 10.3969/j.issn.1006-2084.2014.05.068
[6] Levey AS, Bosch JP, Lewis JB, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group[J]. Ann Intern Med, 1999, 130(6): 461-470. doi: 10.7326/0003-4819-130-6-199903160-00002
[7] Ma YC, Zuo L, Chen JH, et al. Modified glomerular filtration rate estimating equation for Chinese patients with chronic kidney disease[J]. J Am Soc Nephrol, 2006, 17(10): 2937-2944. doi: 10.1681/ASN.2006040368
[8] Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate[J]. Ann Intern Med, 2009, 150(9): 604-612. doi: 10.7326/0003-4819-150-9-200905050-00006
[9] 陈利翔, 杨桂芝, 李高兰, 等. 肌酐与胱抑素C计算肾小球滤过功能的方法比较[J]. 医学检验与临床, 2012, 23(2): 80, 85.
[10] 付帅, 徐丝, 杨敏, 等. 血清胱抑素C公式和肌酐公式对评估中国人肾小球滤过率精准度的比较[J]. 临床肾脏病杂志, 2020, 20(5): 351-356, 384. doi: 10.3969/j.issn.1671-2390.2020.05.001
[11] Levin A, Tevens PE. Summary of KDIGO 2012 CKD Guideline: behind the scenes, need for guidance, and a framework for moving forward[J]. Kidney Int, 2014, 85(1): 49-61. doi: 10.1038/ki.2013.444
[12] Feng JF, Qiu L, Zhang L, et al. Multicenter study of creatinine-and/or cystatin C-based equations for estimation of glomerular filtration rates in Chinese patients with chronic kidney disease[J]. PLoS One, 2013, 8(3): e57240. doi: 10.1371/journal.pone.0057240
[13] National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification[J]. Am J Kidney Dis, 2002, 39(2 Suppl 1): S1-S266.
[14] Mir MC, Campbell RA, Sharma N, et al. Parenchymal volume preservation and ischemia during partial nephrectomy: functional and volumetric analysis[J]. Urology, 2013, 82(2): 263-268. doi: 10.1016/j.urology.2013.03.068
[15] Takagi T, Mir MC, Sharma N, et al. Compensatory hypertrophy after partial and radical nephrectomy in adults[J]. J Urol, 2014, 192(6): 1612-1518. doi: 10.1016/j.juro.2014.06.018
[16] Kim DK, Jang Y, Lee J, et al. Two-year analysis for predicting renal function and contralateral hypertrophy after robot-assisted partial nephrectomy: A three-dimensional segmentation technology study[J]. Int J Urol, 2015, 22(12): 1105-1111. doi: 10.1111/iju.12913
[17] Mir MC, Ercole C, Takagi T, et al. Decline in renal function after partial nephrectomy: etiology and prevention[J]. J Urol, 2015, 193(6): 1889-1898. doi: 10.1016/j.juro.2015.01.093
[18] Delpassand ES, Homayoon K, Madden T, et al. Determination of glomerular filtration rate using a dual-detector gamma camera and the geometric mean of renal activity: correlation with the Tc-99 m DTPA plasma clearance method[J]. Clin Nucl Med, 2000, 25(4): 258-262. doi: 10.1097/00003072-200004000-00004
[19] 梁丽, 彭烨, 吴震杰, 等. 99 mTc-DTPA GFR评估气腹-热缺血损伤腹腔镜下肾部分切除术后术侧和健侧肾功能变化[J]. 山西医科大学学报, 2013, 44(5): 391-393. doi: 10.3969/J.ISSN.1007-6611.2013.05.019
[20] Sankin A, Sfakianos JP, Schiff J, et al. Assessing renal function after partial nephrectomy using renal nuclear scintigraphy and estimated glomerular filtration rate[J]. Urology, 2012, 80(2): 343-346. doi: 10.1016/j.urology.2012.04.054
[21] Lee CH, Park YJ, Ku JY, et al. Clinical application of calculated split renal volume using computed tomography-based renal volumetry after partial nephrectomy: Correlation with technetium-99 m dimercaptosuccinic acid renal scan data[J]. Int J Urol, 2017, 24(6): 433-439. doi: 10.1111/iju.13338
[22] Bertolo R, Fiori C, Piramide F, et al. Assessment of the relationship between renal volume and renal function after minimally-invasive partial nephrectomy: the role of computed tomography and nuclear renal scan[J]. Minerva Urol Nefrol, 2018, 70(5): 509-517.
[23] Marconi L, Desai MM, Ficarra V, et al. Renal Preservation and Partial Nephrectomy: Patient and Surgical Factors[J]. Eur Urol Focus, 2016, 2(6): 589-600. doi: 10.1016/j.euf.2017.02.012
[24] Soga S, Britz-Cunningham S, Kumamaru KK, et al. Comprehensive comparative study of computed tomography-based estimates of split renal function for potential renal donors: modified ellipsoid method and other CT-based methods[J]. J Comput Assist Tomogr, 2012, 36(3): 323-329. doi: 10.1097/RCT.0b013e318251db15
[25] 刘鹏飞, 侯广东, 倪建鑫, 等. 保留肾单位手术后肾功能预后的影响因素分析[J]. 中华泌尿外科杂志, 2020, 41(3): 179-184. doi: 10.3760/cma.j.cn112330-20190530-00254
[26] Lai GS, Hung SC, Chang LW, et al. Renal volume matters: Assessing the association between excisional volume loss and renal function after partial nephrectomy[J]. Asian J Surg, 2020, 43(1): 257-264. doi: 10.1016/j.asjsur.2019.05.015
[27] Plattner HS, Sundaram CP, Cheng L, et al. Renal Volume Loss During Partial Nephrectomy Due to Resected Healthy Parenchyma: A Tool for Quick Estimation[J]. J Endourol, 2020, 34(8): 856-861. doi: 10.1089/end.2020.0314
[28] Sharma N, O'Hara J, Novick AC, et al. Correlation between loss of renal function and loss of renal volume after partial nephrectomy for tumor in a solitary kidney[J]. J Urol, 2008, 179(4): 1284-1288. doi: 10.1016/j.juro.2007.11.071
[29] Mitsui Y, Sadahira T, Araki M, et al. The 3-D Volumetric Measurement Including Resected Specimen for Predicting Renal Function AfterRobot-assisted Partial Nephrectomy[J]. Urology, 2019, 125: 104-110. doi: 10.1016/j.urology.2018.12.020
[30] 刘波, 梁明龙, 张久权, 等. 动脉自旋标记MRI评估2型糖尿病患者肾皮质灌注水平[J]. 中国医学影像技术, 2017, 33(5): 747-751. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYXX201705037.htm
[31] 温成龙, 任涛, 陈丽华, 等. 动脉自旋标记MRI评价肾癌部分切除术后残余肾功能的价值[J]. 中国医学影像学杂志, 2017, 25(7): 555-558. doi: 10.3969/j.issn.1005-5185.2017.07.021
[32] 张莎莎, 蒲伟, 徐超, 等. 动脉自旋标记MRI技术在肾癌部分切除术后残余肾功能评估中的作用分析[J]. 医药前沿, 2018, 8(34): 134. doi: 10.3969/j.issn.2095-1752.2018.34.117
[33] 黄晓霞, 叶裕丰, 张徐雯, 等. 体素内不相干运动的扩散加权像在肾病中的研究进展[J]. 中华介入放射学电子杂志, 2019, 7(2): 155-159. doi: 10.3877/cma.j.issn.2095-5782.2019.02.012
[34] 杨莹, 俞胜男, 蒋振兴, 等. 体素内不相干运动预测肾小球滤过率的初步研究[J]. 临床放射学杂志, 2016, 35(11): 1690-1692. https://www.cnki.com.cn/Article/CJFDTOTAL-LCFS201611015.htm
[35] 温成龙. fMRI纵向评估肾癌患者腹腔镜下肾部分切除术后余肾功能的初步研究[D]. 天津: 天津医科大学, 2017: 1-71.
[36] Shah PH, Moreira DM, Okhunov Z, et al. Positive Surgical Margins Increase Risk of Recurrence after Partial Nephrectomy for High Risk Renal Tumors[J]. J Urol, 2016, 196(2): 327-334. doi: 10.1016/j.juro.2016.02.075
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