450例肾细胞癌的临床回顾性分析

A Retrospective Study of 450 Cases of Renal Cell Carcinoma（RCC）

目的：探讨肾细胞癌的临床特征、预后因素及诊治情况。方法：对1999年1月至2005年1月期间450例肾细胞癌患者的临床特征、诊疗方法和预后情况进行回顾性分析。结果：450例患者中，男287例，女163例，平均年龄54．2岁。术后病理提示，透明细胞癌375例，颗粒细胞癌40例，其它类型肾细胞癌35例。临床分期为T1NOM0267例，T2NOM0142例，T3期以上（含乃期）41例，其中偶发肾癌263例，有症状肾癌187例。行肾癌根治性切除术372例，保留肾单位手术78例，其中静脉癌栓取出术8例，术后行α-干扰素治疗161例。平均随访时间37个月（4个月～60个月）。结论：B超、CT是目前肾癌早期诊断的重要手段；早期行根治性肾切除术仍是最有效的治疗方法，保留肾单位的肾部分切除对于局限性小肾癌而言是一项可供选择的手术方法，尤其适合对侧合并肾脏疾病的患者；联合生物治疗对肾细胞晚期病人的作用有一定效果。

Objective：To study the correlation of clinical characteristic, prognosis, diagnosis and treatment of renal cell carcinoma. Me/hods：450 cases of renal cell carcinoma were reviewed for their incidence, diagnosis, treatment and prognosis. A retrospective analysis was made to reveal the correlation of clinical characteristic , diagnosis , treatment and prognosis of 450 cases of renal cell carcinoma. Results：450 cases of patients, male （287cases） , female （163 cases）, the average age is 54.2. Among which 375 cases were clear cell carcinoma, 40 cases were granular cell carcinoma and 35 cases were other cell typers, and 263 cases were incidental, 187 cases were symptomatic. 372 cases were accepted for Radical nephrectomy, 78 cases accepted the Nephron sparing surgery（NSS） , Radical nephrectomy plus tumor thrombus removing guarantee was performed for 8 cases, 161 cases were treated with the medicine of Interferon, 356 cases had been followed up and 57 cases had died. Conclusions： B type ultrasonography and computerized tomography are important measures in the early diagnosis of renal cell carcinoma. In early stage, the most effective treatment is Radical nephrectomy. Nephron sparing surgery is an available method for renal cell carcinoma patients with small, localized tumors, especially fit for the patients with renal cell carcinoma. Combining interferon therapy is certainly effective to patients with advanced stage renal cell carcinoma.