囊性肾细胞癌微创治疗时代一些值得重视的问题

Diagnosis and Treatment of Cystic Renal Cell Carcinoma

目的 提高对囊性肾癌的认识。方法 对 11例囊性肾癌的临床、超声和CT特点 ,以及病理学特征、手术方式和预后进行回顾性分析。结果 11例中行根治性肾切除 10例 ,肾部分切除 1例 ,术后病理均为囊性肾透明细胞癌 ,9例获随访 5～ 13 2个月 ,无肿瘤转移和复发。结论 CT在囊性肾癌的术前诊断中是一种有价值的常用检查方法。对术前怀疑囊性肾癌者 ,术中需做病理检查 ,确诊者宜行根治性肾切除或肾部分切除。熟悉囊性肾癌的病理学和影像学特征是提高诊断准确率的关键。囊性肾癌预后良好。

Objective To improve recognization for cystic renal cell carcinoma (RCC). Methods The clinical features, image characteristics, pathology, approach of surgery and prognosis of 11 cases of cystic RCC were retrospectively analyzed. Results Radical nephrectomy was performed in 10 cases and partial nephrectomy was applied to 1 case. All the 11 cases were confirmed as cystic renal clear cell carcinoma after operation by pathological examination. 9 patients were followed up for 5～132 months, and the overall outcomes were excellent with no evidence of cancer recurrence or metastasis. Conclusion The CT was a useful way in diagnosing cystic RCC, and intraoperative pathological examination should be performed in the suspected cases of cystic RCC. Radical nephrectomy or partial nephrectomy should be performed for cystic RCC. Understanding the pathological and imaging characteristics of cystic RCC was the key factor to improve the diagnosis of cystic RCC.