成人肾母细胞瘤的诊治分析(附7例报告并文献复习)

Diagnosis and treatment of adult Wilms tumor ( report of 7 cases and literature review)

目的：探讨成人肾母细胞瘤的诊断和治疗方法。方法：回顾性分析天津医科大学第二医院7例成人肾母细胞瘤的临床资料。其中男4例，女3例，平均年龄33岁，肿瘤平均直径9cm。结果：7例患者按照美国国家肾母细胞瘤研究组分期：Ⅰ期2例，Ⅱ期3例，Ⅲ期1例，Ⅳ期1例。7例均行根治性肾切除术，术后病理均证实为肾母细胞瘤，辅以放疗及化疗。随访时间3～72个月，中位随访时间30个月，其中1例患者失访，3例患者已经死亡，1例患者出现肿瘤复发并带瘤生存，2例患者无瘤生存，中位生存时间36个月。结论：成人肾母细胞瘤是一种比较少见的恶性肿瘤，术前确诊困难，病理检查是诊断成人肾母细胞瘤的金标准。早期诊断、手术治疗、辅以放疗和化疗等可明显提高治愈率并改善预后。

Objective： To investigate the methods of diagnosis and treatment of adult Wilms tumor. Methods ： Seven cases of a- dult Wilms tumor were analyzed retrospectively and discussed with review of literature. The patients, four male and three female, were aged 33 years. The size of tumors ranged from 5 to 16 cm （ mean 9cm） in diameter. Results： According to National Wilms Tumor Study （NWTS） staging, there were four cases of stage, two cases of stage I , three cases of stage II , one case of stage III and one case of stage IV. AU patients received radical nephrectomy, adjuvant radio therapy and chemotherapy postoperatively. All cases were confirmed as AWT by postoperative pathology. The range of the follow - up time was 3 to 72 months, and the median follow - up period was 30 months. One patient lost the follow up, three patients died, one patient survived with tumor recurrence, and two patients survived without tumor recurrence. The median survival period was 36 months, and one patient lost the follow- up. Conclusion：Adult Wilms＇ tumor is a rare malignant tumor and is difficult to be diagnosed preoperatively. Pathological diagnostic is the standard diagnostic method. The early diagnosis and treatment including nephrectomy as early as possible and adjuvant radiotherapy and chemotherapy could improve the cure rate and prognosis.