成人肾母细胞瘤的诊治和预后

Diagnosis,treatment and prognosis of adult nephroblastoma

目的探讨成人肾母细胞瘤的病理特点、诊疗方法和预后。方法回顾性分析13例成人肾母细胞瘤患者的临床资料。结果12例患者行肾肿瘤根治性切除术,1例行姑息手术,其中预后良好组织型(FH)4例,预后不良组织型(UH)9例,术后均进行化疗及放疗。3例预后良好组织型患者无瘤生存。结论青年人出现血尿及腰腹部生长迅速的巨大包块,应警惕本病可能。病理检查是诊断成人肾母细胞瘤的金标准。肿瘤血管具有特征性的"波浪状"血管造影表现。对于成人肾母细胞瘤均应采取手术、化疗、放疗相结合的综合治疗。

Objective To probe into pathology,diagnosis , treatment and prognosis of adult nephroblastoma. Methods Thirteen cases of adult nephroblastomas were analysed retrospectively and discussed with review of literature. Results Twelve patients were treated with radical nephrectomy and 1 case was treated with palliative operation. Four cases were favorable histology （FH） and 9 cases were unfavorable histology （UH）. All patients were treated with chemotherapy, radiotherapy after initial operation. Three ca ses of FH were free of tumor. Conclusion Young adults presented with hematuria and a large, rapidly growing, abdominal mass should be noticed. Pathological diagnostic is the standard diagnostic method. ＂Wavy＂ neovaseularity on arteriography is characteristic and is suggestive of the disease. Aggressive multimodal treatment, namely a well timed combination of surgery, chemotherapy and radiotherapy should be given to all patients.