14例肾嗜酸细胞瘤的临床病理分析

Clinical and pathological analysis of 14 cases renal oncocytoma

目的探讨肾嗜酸细胞瘤的诊断和治疗。方法回顾分析2006年5月至2010年12月收治的14例肾嗜酸细胞瘤患者的临床资料。结果 14例患者术前影像学诊断提示肾癌,均缺乏临床特征;其中男女各7例,年龄44～77岁,平均(60.3±9.8)岁;7例行根治性肾切除术,7例行部分切除术,肿瘤大小为1.5～7cm,平均(3.5±1.7)cm。1例失访,余13例随访5～48个月(平均21.4个月),无复发及转移。结论肾嗜酸细胞瘤是少见的肾良性肿瘤,术前根据影像学诊断难以与肾癌相鉴别,经皮穿刺活检被认为是一种安全、准确的术前诊断方法。对于肾脏小肿瘤,肾部分切除术结合术中冰冻切片依然是目前最适合的诊疗手段,密切随访同样重要。

Objective To investigate and improve the diagnostic and therapeutic feature of renal oncocytoma（RO）.Methods The clinical data of 14 cases of patients with RO from May 2006 to December 2010 were analyzed retrospectively.Results All the 14 cases were diagnosed as renal cell carcinoma（RCC） by radiological imaging detection.There was no specificity of the clinical presentation in all the cases.The study population comprised 7 men and 7 women,and the mean age was（60.3±9.8） years（range 44-75 years）.Seven were treated with radical nephrectomy,and 7 with partial nephrectomy.Mean tumor size was 3.5±1.7 cm（range 1.5-7cm）.One patient was lost to follow-up,and there was no recurrence or death in the remaining 13 patients who were followed-up for a mean duration of 21.4 months（range 5-48 months）.Conclusion RO is a rare kind of benign renal tumors.It is difficult to differentiate preoperatively renal oncocyma from renal carcinomas by radiological imaging techniques.Percutaneous biopsy is considered a safe and accurate method of diagnosis.Thus,nephron-sparing surgery（NSS） associated with pathological detection of frozen section is the first choice treatment,especially in patients with small tumors.Further more,follow-up is essential.