32例囊性肾细胞癌诊治分析

陈迎涛; 马潞林; 张树栋; 黄毅; 侯小飞; 王国良

32例囊性肾细胞癌诊治分析

- 北京大学第三医院泌尿外科(北京, 100191)

详细信息

通讯作者: 马潞林,E-mail:malulin@medmail.com.cn

中图分类号: R737.11

收稿日期: 2012-07-23

Diagnosis and treatment of cystic renal cell carcinoma: a study of 32 cases

- Department of Urology, Peking University Third Hospital, Beijing, 100191, China

More Information

Corresponding author: MA Lulin, E-mail: malulin@medmail.com.cn

Received Date: 23 July 2012

摘要

摘要: 目的：加深对囊性肾细胞癌的认知，提高囊性肾细胞癌的诊治水平。方法：回顾性分析2007~2011年收治的32例具有显著囊性特点的肾细胞癌患者的临床表现、影像学、病理学及治疗手段等临床资料。结果：囊性肾细胞癌无特征性临床表现，术前影像学检查可以提供诊断线索。28例为囊性变性肾细胞癌，4例为多房囊性肾细胞癌。21例行根治性肾切除术，10例行肾部分切除术，1例行患侧根治性肾切除及输尿管全长切除术。31例获得随访，平均随访期为18.0个月（4~49个月）。结论：囊性肾细胞癌是一类在影像学和大体病理上具有显著囊性改变的肾癌统称，临床上主要关注多房囊性肾细胞癌和囊性变性肾细胞癌两种亚型，两者在预后上存在巨大差异，应采取不同的治疗方式。
- 囊性肿瘤 /
- 肾细胞癌 /
- 诊断 /
- 肾切除术
Abstract: Objective: To enhance the understanding and improve the diagnostic and treatment level of cystic renal cell carcinoma.Methods: A total of 32(24 males, 8 females)RCCs with prominent cystic feature were identified from 2007 to 2011 in Peking University Third Hospital. The epidemiological, pathologic, clinical, radiological features and treatment information of 32 cases of CRCC were retrospectively analyzed.Results: The clinical features of CRCC were similar to those of non CRCCs. Histopathologic examination demonstrated 28 cases of renal cell carcinoma with cystic change, 4 multilocular cystic renal cell carcinoma. Radical nephrectomy was performed in 21 cases and partial nephrectomy was performed in 10 cases. One patient underwent unilateral nephroureterectomy. 31cases were followed. The mean followup period was 18.0 months (ranging from 4 to 49 months).Conclusions: Cystic renal cell carcinoma refers to any type of renal carcinomas with prominent cystic features on imaging and general pathology, with 2 major subtypes (multilocular cystic renal cell carcinoma and renal cell carcinoma with cystic change) were concerned clinically. The two should be taken of the different methods of treatment for their big differences in prognosis.
- cystic neoplasms /
- renal cell carcinoma /
- diagnosis /
- nephrectomy

HTML全文

参考文献(19)

[1]	Israel G M, Bosniak M A. An update of the bosniak renal cyst classification system[J]. Urology, 2005, 66(3):484-488.
[2]	Blute M L, Leibovich B C, Lohse C M, et al. The Mayo Clinic experience with surgical management, complications and outcome for patients with renal cell carcinoma and venous tumour thrombus[J]. BJU Int, 2004, 94(1):33-41.
[3]	Hartman D S, Davis C J Jr, Johns T, et al. Cystic renal-cell carcinoma[J]. Urology, 1986, 28:145-153.
[4]	Corica F A, Iczkowski K A, Cheng L, et al. Cystic renal cell carcinoma is cured by resection:a study of 24 cases with long-term followup[J]. J Urol, 1999, 161:408-411.
[5]	Bielsa O, Lloreta J, Gelabert-Mas A. Cystic renal cell carcinoma:pathological features, survival and implications for treatment[J]. Br J Urol, 1998, 82(1):16-20.
[6]	刘犇,陈军,姜海,等. 囊性肾癌14例临床诊治分析[J]. 中华医学杂志.2011, 91(40):2861-2862.
[7]	Bruun E, Nielsen K. Solitary cyst and clear cell adenocarcinoma of the kidney:report of 2 cases and review of the literature[J]. J Urol, 1986, 136:449-451.
[8]	Lopez-Beltran A, Scarpelli M, Montironi R, et al. 2004 WHO classification of the renal tumors of the adults[J]. Eur Urol, 2006, 49:798-805.
[9]	Halat S, Eble J N, Grignon D J, et al. Multilocular cystic renal cell carcinoma is a subtype of clear cell renal cell carcinoma[J]. Mod Pathol, 2010, 23(7):931-936.
[10]	Onishi T, Oishi Y, Goto H, et al. Cyst-associated renal cell carcinoma:clinicopathologic characteristics and evaluation of prognosis in 27 cases[J]. Int J Urol, 2001, 8(6):268-274.
[11]	Ascenti G, Mazziotti S, Zimbaro G, et al. Complex cystic renal masses:characterization with contrast-enhanced US[J]. Radiology, 2007, 243:158-165.
[12]	Park B K, Kim B, Kim S H, et al. Assessment of cystic renal masses based on Bosniak classification:comparison of CT and contrast-enhanced US[J]. Eur J Radiol, 2007, 61:310-314.
[13]	Clevert D A, Minaifar N, Weckbach S, et al. Multislice computed tomography versus contrast-enhanced ultrasound in evaluation of complex cystic renal masses using the Bosniak classification system[J]. Clin Hemorheol Microcirc, 2008, 39(1-4):171-178.
[14]	Israel G M, Bosniak M A. How I do it:evaluating renal masses[J]. Radiology, 2005, 236:441-450.
[15]	Israel G M, Hindman N, Bosniak M A. Evaluation of cystic renal masses:comparison of CT and MR imaging by using the Bosniak classification system[J]. Radiology, 2004, 231:365-371.
[16]	Stamatiou K N, Sofras F. Multilocular cystic nephroma and multicystic clear cell carcinoma:two faces of the Roman god Janus?[J]. Int J Surg Pathol, 2009, 17:170-171.
[17]	Suzigan S, López-Beltrán A, Montironi R, et al. Multilocular cystic renal cell carcinoma:a report of 45 cases of a kidney tumor of low malignant potential[J]. Am J Clin Pathol, 2006, 125:217-222.
[18]	Brinker D A, Amin M B, de Peralta-Venturina M, et al. Extensively necrotic cystic renal cell carcinoma:a clinicopathologic study with comparison to other cystic and necrotic renal cancers[J]. Am J Surg Pathol, 2000, 24(7):988-995.
[19]	Brinker D A, Amin M B, de Peralta-Venturina M, et al. Epstein, Extensively necrotic cystic renal cell carcinoma:a clinicopathologic study with comparison to other cysticand necrotic renal cancers[J]. Am J Surg Pathol, 2000, 24(7):988-995.