肾嫌色细胞癌33例临床分析及文献复习

Chromophobe cell renal carcinoma:Clinical analysis and review of 33 cases

目的探讨肾嫌色细胞癌(chromophobe cell renal carcinoma,CRCC)的临床特点、诊治方法及预后。方法回顾性分析四川大学华西医院2001年9月至2010年3月经病理检查证实的33例CRCC患者的临床资料,结合相关文献复习并进行讨论。结果 33例患者首发症状均无明显特异性,均行B超、CT等影像学检查提示肾区实质性占位病变,均为一侧肾脏单发肿块;所有患者均采用单纯手术治疗,未联合运用放疗和化疗等辅助性治疗手段;术后标本行HE染色及免疫组化检查,均证实为CRCC;在获得随访的29例行肾癌根治术的患者中,5例术后出现远处转移,另外4例行保留肾单位肾肿瘤剜出术,随访2年,均无瘤存活。结论 CRCC是一种低度恶性的肾细胞癌,确诊有赖于典型病理表现,治疗以手术为主,预后较好。

Objective To investigate the clinical features, diagnosis, treatment and prognosis of chromophobe cell renal carcinoma （CRCC）. Methods Clinical data of 33 cases of CRCC were studied retrospectively and pertinent literature was reviewed. Results There was no significant specificity in the initial symptoms of 33 patients. Type-B ultrasonic, CT and other diagnostic imaging techniques suggested substantial lesions （ single mass in one side of the kidney） in renal region. All the patients were treated by surgery alone,without any radiotherapy and chemotherapy. The patients were finally confirmed as CRCC after HE staining and immunohistochemistry techniques. Twenty-nine cases were followed-up. Five cases had metastasis in distant places. The other 4 cases that received nephron sparing surgery were followed up for 2 years and all survived disease-free. Conclusion CRCC is a low potential malignancy renal cell carcinoma. Its diagnosis based on pathologic findings. Surgery is a suggested choice for good prognosis.