肾集合管癌的临床分析

Clinical analysis of renal collecting duct carcinoma

目的：探讨肾集合管癌的临床特征、诊疗及预后.方法：回顾性分析18例肾集合管癌患者的临床资料.结果：18例中男性患者11例、女性为7例,发病年龄39～71岁,平均54.8岁.因血尿就诊11例,因腰痛就诊4例,因腰痛伴反复低热就诊1例,查体发现2例.18例均行手术治疗,术后给予辅助治疗.15例随访3个月～3年,其中1例术后3个月时发现肺转移,9个月死于肾癌转移,8例于术后1～2年之间死于肾癌肺或脑转移,3例术后2～3年之间死于肾癌转移,3例术后3～9个月仍无瘤生存,3例患者失访.结论：肾集合管癌恶性程度高,进展迅速,转移早,预后差.单纯手术治疗效果一般.免疫治疗及靶向治疗前景较好.

Objective：To discuss the clinical features,diagnosis,treatment and prognosis of renal collecting duct carcinoma （renal Bellini duct carcinoma）.Methods：Eighteen cases of renal Bellini duct carcinoma were retrospectively analyzed.Results：Eleven males and 7 females,with ages of onset ranging from 39 to 71 years old （mean 54.8 years） were tested.Eleven cases saw a doctor because of gross hematuria,4 due to osphyalgia,1 case presented with backache accompanied with recurrent fever,2 patients were diagnosed during routine examination.Surgical treatment was performed to all of the 18 patients with renal Bellini duct carcinoma and most of them accepted adjuvant therapy post-operation.Fifteen cases were followed up for 3 months to 3 years：one of them was diagnosed with lung metastases 3 months after operation and died half a year later;,8 cases died of lung metastases or brain metastases one or two years after surgery; 3 cases died of metastatic renal cell carcinoma two or three years after operation; 3 of them still survived with no carcinoma for 3 to 9 months after surgery;and 3 patients were lost during follow-up.Conclusion：Renal Bellini duct carcinoma is a distinctive renal cell carcinoma with high degree of malignancy,rapid progress and poor prognosis.The efficacy of surgery treatment alone is limited while immunotherapy and targeted therapy are of good prospects.