肾嗜酸细胞腺瘤的临床研究

Clinical research on renal oncocytoma

目的：探讨肾嗜酸细胞腺瘤（renaloncocytoma，RO）的临床及病理学特点，提高对该病的诊治水平。方法：回顾性分析我院2008～2014年收治的7例RO患者的临床资料：男3例，女4例，年龄30～63岁，平均40岁。5例因体检发现，2例因腰部酸痛不适就诊发现；7例行CT、MRI、超声等影像学检查均有阳性发现。肿瘤均为单侧单发，位于左。肾6例，右肾1例。肿瘤直径在2．5～10cm，平均5．06cm。6例行肾脏部分切除术，1例行肾肿瘤根治性切除术。结果：本组7例患者均痊愈出院。其中1例失访，6例随访，随访时间2～56个月，中位随访时间45个月，均未发现肿瘤复发或远处转移。术后病理检查报告均为RO。结论：RO是一种少见的肾脏良性肿瘤，多无临床表现，影像学检查均有阳性发现，典型病例有特异性影像学表现，但大多无特异性表现。不推荐术前穿刺活检，术中快速冷冻切片检查有一定意义。确诊有赖于病理检查及免疫组织化学分析。治疗上以保留肾单位手术为首选，术后需定期随访。

Objective： To discuss the clinical and pathological features of renal oncocytoma （RO） and to im- prove the diagnosis and treatment. Method：Clinical data of seven cases with RO treated from 2008 to 2014 in our hospital were retrospectively analyzed. There were three males and four females, aging from 30 to 63 years with a mean of 40 years old. Five of them were asymptomatic while others complained of lumbago. Six tumors were on the left, and one on the right. The maximum diameter of tumor was 2.5-10 （mean, 5.06） cm. Radical nephrecto- my was performed in one case, and six patients underwent partial nephrectomy. Result： All patients were cured. Postoperative pathological results confirmed the diagnoses of RO in all patients. Six cases were followed up for 2- 56 （median, 45） months. Only one patient was left without follow-up. No recurrence or distant metastasis was found. Conclusion： RO is an uncommon benign tumour without clinical manifestation. Imaging tests were positive, but there is no specific performance except typical cases. Preoperative biopsy is not recommended. Intraoperative frozen section may be helpful. Final diagnosis should be hased on pathology and immunohistochemistry. Nephron- sparing surgery should be the optimal choice and postoperative periodical follow-ups are needed.