儿童不同病理类型肾脏肿瘤的鉴别与诊断

Differential diagnosis of different pathologic types of renal tumors in children

儿童肾脏肿瘤可分为肾母细胞瘤[nephroblastoma,又称威尔姆斯瘤(Wilms tumors,WT)]与非肾母细胞瘤肾肿瘤(non-Wilms renal tumors,NWRTs)两大类。WT为恶性肿瘤,早期文献报道占儿童肾脏肿瘤的90%~95%。NWRTs病理类型具有异质性,部分为良性肿瘤。儿童肾肿瘤的治疗方案和治疗结局多样,不同病理类型患儿预后差异显著,精准诊断尤为重要。术前推断肾脏肿瘤病理类型,可辅助选择合理的手术方式;而术后明确诊断肾脏肿瘤病理类型,是后续治疗的依据。本文重点论述儿童不同病理类型肾脏肿瘤的鉴别诊断,以期指导临床合理选择治疗方式,改善患儿预后。

Renal tumors in children can be classified into two categories of nephroblastoma and non-Wilms renal tumors(NWRTs).Among them,nephroblastoma is a malignant tumor accounting for about 90%-95%of pediatric renal tumors reported in early literature.The pathological types of NWRTs are heterogeneous and some of them were benign.Treatment options and clinical outcomes of pediatric renal tumors are diverse and the prognosis is significantly different with different pathological types.A precise diagnosis is particularly important.Preoperative clinical inference of the pathological type of renal tumor can assist in selecting a reasonable surgical approach and pathological type of postoperative renal tumor is a gold standard for subsequent treatment.Therefore this review focused upon the differential diagnosis of renal tumors in children with different pathological types to guide the selection of reasonable treatments and improve the prognosis of children.