多房性囊性肾癌与肾癌出血坏死囊性变的临床对比分析

Clinical comparison of multilocular cystic renal carcinoma and cystic degeneration of kidney cancer hemorrhage and necrosis

目的探讨多房性囊性肾癌（MCRCC）与肾癌出血坏死囊性变（RCCC）的临床病理特点,提高诊治水平。方法收集2000～2012年以囊性成分为主的肾细胞癌20例,对7例NCRCC及13例NCRCC的临床病理资料进行对比研究,并对其囊壁、间隔增厚、结节大小等CT征象以及病理分级进行统计学分析。结果 MCRCC组多在体检中发现,而NCRCC组多有局部或肾外表现。最重要的CT征象为囊壁及分隔局部结节或肿块,与MCRCC组相比差异有显著性P〈0.05。MCRCC组病理分级低,与NCRCC组相比差异有显著性P〈0.05。结论MCRCC与NCRCC是两种生物学行为不同的肾癌类型,应注意鉴别,主要依靠影像学检查。MCRCC恶性程度低,预后较好。

Objective To differentiate the clinical pathologic features between muhilocular cystic renal cell carcinoma （MCRCC） and necrotic cystic renal cell carcinoma （NCRCC） . Methods The clinical, radiographic and pathologic data of 20 cases （ 7 MCRCC and 13 NCRCC） were reviewed retrospectively （ 2004 -2012） , the pathologic grading and the CT features of each cystic mass in two groups, including focal thickening and enhancement of wall or septa, the calcification, as well as the high signal intensity were compared. Results The differential diagnosis between them were mainly depended on imaging study. The presence of septal and wall thickening or nodular as the most important sign to differentiate NCRCC from MCRCC （ P 〈 0. 05 ） . Tumors in NCRCC group tended to be of higher pathologic grade than that in MCRCC group （ P 〈 0. 05 ）. Conclusion MCRCC and NCRCC are two distinct types of renal cell carcinoma Which must not be confus- ed, MCRCC has a lower malignant potential arid a better prognosis compared with NCRCC.