摘要
本文报道14例年龄小于20岁的青少年肾细胞癌,占我院30年间收治肾细胞癌的5.5%,且近10年发现的病例明显多于过丧20年.由于男性患者多,发病率低,出现血尿时,易误诊为肾炎、肾结核.若仅出现腹部肿块,往往只考虑肾母细胞瘤、神经母细胞瘤等.青少年出现腹部包块、内眼血尿应想到肾癌的可能,需及时行IVP、B超、CT检查.症状中腹部肿块较成人组发生率高,血尿较肾母细胞瘤发生率高.X线平片可出现环状钙化影.病理特点是出现乳头状结构及钙化率高.本组2年生存率65%,其预后主要与临床分期有关.治疗以根治术为主.青少年肾癌有源于集合管的倾向.
Fourteen cases of renal cell carcinoma aged under 20 years are reported. accounting for 5. 5 % in all cases of renal cell.careinare in our hospital in 30 years. Most of them were male. Diagnosis were of ten delayed, belng misdiagnosed as glumerulonephritis,renal tuberculosis, nephroblastoma and neuroblastoma. IVP, B-ultrasonography and CT scanning were usually necessary for patients complained of a mass in renal area or hematuria. An abdorminal mass was palpable in 50% of patients. Hematuria was present in 57% cases. The calcification of the renal cell carcinoma was present in one patient in our group on plain film of abdomen X- ray. The average diameer of the tumor wes 8. 1cm. The papillary pattern was the most common,one of 14 cases was interpreted as a papillary carcinoma of the Bellini's ducts. The overall two-year survival rate was 65 %. The cinical stage and pseudocapsule formation were the important factors related to the survival rate. Redical nephrectomy is still the treatment of choice.
关键词
肾癌
预后因素
青少年
病理
Renal cell carcinoma Adolescence Youngsters