肾嫌色细胞癌33例临床分析

Study of 33 cases of chromophobe renal cell carcinoma

目的 分析肾嫌色细胞癌的临床和病理特征,探讨该病的治疗及预后,提高对该病的诊治水平.方法 回顾性分析2009年1月至2013年9月收治的33例肾嫌色细胞癌患者的资料.男13例,女20例;年龄19～76岁,平均55岁.病变位于左肾18例,右肾15例;33例术前行B超检查,30例行CT扫描,3例行MRI检查.结果 33例均行手术治疗,其中行根治性肾切除术15例,保留肾单位手术5例,腹腔镜下根治性肾切除术11例,腹腔镜下保留肾单位手术2例.术中均未见肾门淋巴结肿大.肿瘤平均直径5.2 cm.病理分期：23例pT1N0M0,6例pT2N0M0,2例pT3N0M0,2例pT1N0M1.Fuhrman分级：Ⅰ级1例,Ⅱ级19例,Ⅲ级9例,Ⅳ级4例.26例患者获得随访,中位随访时间24个月,无出现复发或因肿瘤导致死亡者.结论 肾嫌色细胞癌是肾细胞癌的一种少见类型,手术切除是主要的治疗方式.肾嫌色细胞癌较少复发和转移,预后良好.

Objective To improve the diagnosis and treatment of chromophobe renal cell carcinoma （CRCC）,we investigated and summarized the clinical and pathological features of CRCC patients in our hospital.Methods We have retrospectively analyzed the clinical features of 33 CRCC patients.The mean age of these patients at diagnosis was 55 years-old,including 13 males and 20 females.All tumors were localized unilaterally,with 18 in left kidney and 15 in right kidney.Ultrasonography was performed on all patients,CT scan on 30 patients and MRI on 3 patients.Results All of the patients underwent surgery.Fifteen patients underwent radical nephrectomy,11 patients underwent laparoscopic radical nephrectomy,5 patients underwent nephron sparing surgery and 2 patients underwent laparoscopic nephron sparing surgery.The average diameter of tumors was 5.2 cm.Among them,23 patients were at pT1N0M0,6 at pT2N0M0,2 at T3N0M0 and 2 at T3N0M0.The pathologic Fuhrman grade of CRCC was G1 in 1 case,G2 in 19 cases,G3 in 9 cases and G4 in 4 cases.Twenty-six patients were followed up with a mean duration of 24 months and no local recurrence was found.Conclusions CRCC is a rare subtype of renal cell carcinoma with little recurrence and metastasis.Surgery was the common treatment for CRCC.Usually,CRCC patients have favorable prognosis.