乳头状肾癌的诊治(附32例报告及文献复习)

The diagnosis and treatment of papillary renal carcinoma (Report of 32cases and review)

目的:提高乳头状肾癌的诊治水平。方法:回顾性分析32例乳头状肾癌患者的临床资料。28例行开放性根治性肾切除术,3例行后腹腔镜下根治性肾切除术,1例行后腹腔镜下肾部分切除。结果:术后病理均为乳头状肾癌。采用2002年AJCC肾癌TNM病理分期:pT1aN0M04例,pT1bN0M014例,pT2aN0M010例,pT2bN0M01例,pT2bN1M01例,pT3aN0M02例,病理分级:G121例,G210例,G31例。28例获16～30个月随访,平均20个月,2例死于心脏病,3例死于脑血管意外,1例局部复发,22例无瘤生存。结论:乳头状肾癌是一种具有特殊形态和表现的少见肾癌类型,部分肾切除及根治性肾切除术是治疗乳头状肾癌的首选方法,与其他类型肾细胞癌相比,乳头状肾癌预后较好。

Objective：Improve the diagnosis and treatment of papillary renal carcinoma. Method：The clinical data of 32 patients with papillary renal carcinoma were analyzed retrospectively. 28 patients were treated with radical nephrectomy, 3 of which were treated by laparoseopic nephrectomy. 1 patient was treated with laparoscopic partial nephrectomy. Result：Post-operation pathology confirm that all the specimen were papillary renal carcinoma, pathology stage （2002 AJCC renal carcinoma TNM pathology stage） ： pT1oNoMo4 cases, pT1oNoMo14 cases, pT2b NoMo10 cases, pT2bNoMo 1 case, p2bTN1Mo 1 case, pT3aNoMo 2 cases, pathology grade： G1 21 cases, G2 10 cases, G3 1 case. 28 patients were followed-up for 16-30 months, mean 20 months. 2 patients died of heart Disease, 3 patients died of cerebrovascular accident, 1 patient suffered from local recurrence, 22 patients tumor-free survive. Conclusion：Papillary renal carcinoma is a kind of rare renal carcinoma with special morphous and characteristic. Radical nephrectomy and partial nephrectomy is the first choice treatment of papillary renal carcinoma. Compared with other kinds of renal carcinoma, it has a better prognosis.