微小肾癌(附31例报告)

Small and minute renal carcinoma

目的 提高偶发小肾癌的诊治效果 ,提出微小肾癌的概念。 方法 采用回顾性研究对偶发小肾癌不同肿瘤直径与预后因素进行相关性分析。 结果 肿瘤直径 2 .0～ 3.0cm者 15例(Ⅰ组 ) ,1.5～ 2 .0cm者 9例 (Ⅱ组 ) ,≤ 1.5cm者 7例 (Ⅲ组 )。 3组肿瘤呈浸润性生长者分别为 3、1、0例 ,肿瘤静脉内浸润者分别为 2、1、0例 ,同侧肾内多发癌者分别为 3、1、0例。Ⅲ组病理分级低 ,与Ⅱ组、Ⅰ组相比较差别有显著性意义 (P <0 .0 5 )。Ⅲ组病理分期低 ,与Ⅱ组相比较差别无显著性意义(P >0 .0 5 ) ,与Ⅰ组相比较差别有显著性意义 (P <0 .0 5 )。肿瘤直径≤ 1.5cm者无远隔转移和术后复发死亡。 结论 偶发肾癌肿瘤直径≤ 1.5cm者预后良好 。

Objective To study the diagnosis and treatment of small renal carcinoma and to bring forth the conception of small and minute renal carcinoma. Methods The association of prognosis and the size of the renal carcinoma was respectively studied and analyzed. Results There were 15 cases with the greatest diameter of the neogrowth 2.0～3.0 cm (group Ⅰ),9 cases with the diameter 1.5～2.0 cm (group Ⅱ) and 7 within 1.5 cm (group Ⅲ). The tumor has been invasive in 3,1 and 0 in the respective group;the tumor being invaded into the vein in 2,1 and 0 cases respectively;being multiple in the ipsilateral kidney in 3,1 and 0. The pathological grading of tumor was low in group Ⅲ being significantly different from those in group Ⅱand group Ⅰ( P <0.05). The rumor staging was also low in group Ⅲ but with no significant difference with those in group Ⅱ whereas it was significantly different from those in group Ⅰ ( P <0.05).When the tumor diameter was within 1.5 cm there has been no distant metastasis or recurrence after surgery. Conclusions Incidental renal carcinoma with the diameter within 1.5 cm would be good in prognosis.The conception of small and minute renal tumor is brought forth.