肾癌的诊断和治疗89例分析

Diagnosis and treatment of renal cell carcinoma: 89 cases of analysis

目的 :研究肾癌的诊断和治疗方法 .方法 :回顾性分析 1 990 0 1 / 2 0 0 3 1 2我院肾癌的诊治过程及其预后情况 .患者 89(男 5 4 ,女 35 )例 ,年龄 1 8～ 87(平均 5 3)岁 .右侧 5 3例 ,左侧 35例 ,双侧 1例 ,合并原发性肝癌 1例 ,位于肾上极36例 ,肾下极 32例 ,中极 2 1例 .全部患者均行B超、静脉肾盂造影和CT检查 ,治疗包括手术、化疗、放疗和生物治疗 .结果 :Ⅰ～Ⅲ期肾癌 6 1例行根治性手术治疗 ,Ⅳ期 2 8例行生物治疗或化疗放疗 ,Ⅲ期 1例行介入栓塞治疗 .随访 2～ 6 6mo ,Ⅰ期全部存活 ,平均生存时间Ⅱ期 30mo ,Ⅲ期 1 6mo,Ⅳ期 3.6mo.结论 :肾癌提高生存时间的关键是早发现早治疗 ,主要诊断方法是医学影像学 ,最有效的治疗是外科手术 。

AIM: To evaluate the diagnosis and treatment of renal cell carcinoma. METHODS: Medical records of 89 patients (male 54, female 35, age ranging from 18 to 87 years) with renal cell carcinoma from 1990 to 2003 were reviewed retrospectively. The right side of the kidney was involved in 53 cases, left side in 35 and double in 1 case. Concomitant primary liver cancer was also observed in 1 case. The superior, lower, and middle pole of kidney was involved in 36, 32, and 21 cases respectively. All the patients underwent ultrasound B, intravenous pyelography and CT examinations. Treatment included operation, chemotherapy, radiotherapy and biotherapy. RESULTS: Sixty one cases in stage Ⅰ, Ⅱ and Ⅲ underwent radical surgery. One case in stage Ⅲ underwent transvascular embolization. Twenty eight cases in stage Ⅳ were treated by biological therapy, chemotherapy or radiotherapy. A 2-66 months of follow up showed that all the cases in stage Ⅰ survived, the average survival time of stage Ⅱ cases was 30 months, 16 months for stage Ⅲ cases and 3.5 months for stage Ⅳ cases. CONCLUSION: The survival time of patients with renal carcinoma can be prolonged through early diagnosis and treatment. The diagnosis of renal cell carcinoma can be made by medical imagology. Radical surgery is the most effective means for early renal cell carcinoma and that for late renal cell carcinoma is biological therapy.