囊性肾癌临床特点及诊治分析

Experience on diagnosis and treatment of cystic renal cell carcinoma

目的：分析囊性肾癌的临床特点，探讨囊性肾癌的诊断及治疗方法。方法回顾性分析12例囊性肾癌患者的临床表现、影像学特征、手术方法、病理特征及随访结果，并结合相关文献就其临床特点进行讨论。结果12例患者术后病理结果透明细胞癌10例，嫌色细胞癌2例。肿瘤直径1．5～8．5cm，平均4．4cm。TNM分期：T1N0M010例，T2N0M02例，其中多房囊性肾癌7例，单房囊性肾癌5例。随访13～78个月，平均39个月，均无复发和转移。结论囊性肾癌早期诊断较为困难，应结合影像学检查、术中冰冻切片及术后病理结果确诊。囊性肾癌恶性度低，预后较好。囊性肾癌同肾癌一样采用肾癌根治术或保留肾单位的手术，保留肾单位的手术为治疗的最佳选择。

Objective To analyze clinical features of cystic renal cell carciuoma （ CRCC） and to investigate the diagnosis and treatment of CRCC .Methods The clinical data of 12 cases with CRCC was analyzed retrospectively .The clinical presen-tation,radiologic features ,surgical procedures ,pathologic features as well as follow -up outcomes of the CRCC were stud-ied.Clinical characteristics were discussed combining references .Results The diagnoses of CRCC were confirmed by post-operative pathology .Histological examination showed that 10 cases of clear cell carcinoma and 2 cases of chromophobe car-cinoma.The size of the tumors ranged from 1.5 cm to 8.5 cm with an average of 4.4 cm.Ten cases were classified as T1N0 M0 and two cases as T2N0M0 for TNM staging.Histopathologic examination demonstrated multilocular cystic renal cell car-cinoma in 7 cases and unilocular cystic renal cell carcinoma in 5 cases.All of the patients remained tumor -free with no ev-idence of neoplastic recurrence or metastasis during a 13 to 78 months （39 months in average ） follow-up.Conclusion Early diagnosis of CRCC is difficult and should be combined with preoperative imaging , intraoperative frozen section and postoperative pathologic examination .Patients with CRCC show relatively good prognosis .CRCC should be treated the same as renal cell carciuoma by radical nephrectomy or partial nephrectomy .Nephron sparing surgery is the optimum choice .