囊性肾癌29例诊治分析

Diagnosis and Therapy of 29 Patients with Cystic Renal Cell Carcinoma

目的加深对囊性肾癌的认知,以提高囊性肾癌的诊治水平。方法回顾性分析29例囊性肾癌患者的流行病学、病理学、临床表现、影像学特征及临床治疗资料。结果囊性肾癌无特征性临床表现,术前影像学检查可以提供诊断线索;29例经病理检查确诊为肾癌囊性变19例,多囊性肾癌7例,单纯性囊肿癌变3例。19例行根治性肾切除术,10例行肾部分切除术。术后27例获得随访,生存时间平均为68个月(4～204个月不等)。结论囊性肾癌是一类在影像学和大体病理上具有囊性改变的肾癌的统称,有3种病理学类型,术前鉴定各亚型是选择手术方式和预后判断的关键。

Objective To assess the diagnosis,treatment and prognosis of cystic renal cell carcinoma（CRCC）.Methods The epidemiological,pathologic,clinical and radiological features of 29 cases of CRCC were retrospectively analyzed.Results The clinical features of CRCC were similar to those of non CRCCs.Histopathologic examination demonstrated 19 cases of renal cell carcinoma cystic degeneration,7 multilocular cystic renal cell carcinoma and 3 preexisting simple cyst cancerization.27 cases were followed.The mean followup period was 68 months（ranging from 4 to 204）.Conclusion Cystic renal cell carcinoma refers to any type of renal carcinomas with cystic features,with 3 different pathological types.Proper diagnosis of the subtype is important in choosing the surgical treatment and assessing the prognosis.