肾嫌色细胞癌28例临床分析并文献复习

Renal chromophobe cell carcinoma: clinical analysis and review of 28 cases

目的分析肾嫌色细胞癌的临床及病理特点以提高对其的诊治水平。方法回顾性分析苏州大学附属第三医院2010年1月至2017年12月收治的28例肾嫌色细胞癌患者的资料,其中男12例,女16例;年龄27~78岁,中位年龄57岁。患者肿瘤均局限于单侧肾脏,其中左肾17例,右肾11例。结果28例患者均行手术治疗,术后病理均证实为肾嫌色细胞癌。7例行开放肾癌根治术,16例行腹腔镜下腹膜后肾癌根治术,5例行腹腔镜下保留肾单位手术。病理分期:pT 1N 0M 0期23例,pT 2N 0M 0期5例。28例患者均获得随访,随访12~72个月,平均24个月,28例患者均无瘤生存,行开放手术和腹腔镜手术患者的预后无明显差异。结论肾嫌色细胞癌是具有特殊形态的少见肾癌类型,确诊有赖于典型的病理特征。手术切除是肾嫌色细胞癌的主要治疗方式,其较少复发和转移,预后良好。

Objective To explore the clinical features of renal chromophobe cell carcinoma(ChRCC)in order to improve its diagnosis and treatment level.Methods From January 2010 to December 2017 in our hospital,the clinical data of 28 cases of ChRCC were analyzed retrospectively.The medium age of 28 cases of CHRCC which had 12 male(42.86%)and 16 female(57.14%)was 57 years from 27 to 78 years.All tumors were localized unilaterally which 17 in left kidney and 11 in right kidney.Results All patients received surgical treatment and postoperative pathological results confirmed the diagnosis of renal chromophobe cell carcinoma.Twenty-three patients underwent radical nephrectomy,including 16 retroperitoneal laparoscopic radical nephrectomy cases and the other five patients underwent nephron sparing surgery,all of which were laparoscopic surgery.The pathologic TNM stage of ChRCC of 28 patients was as follows:pT 1N 0M 0 in 23 cases,pT 2N 0M 0 in 5 cases.All 28 patients were followed up for 12 to 72 months,with an mean of 24 months.All 28 patients survived tumor free.Conclusions ChRCC is a morphologically distinctive uncommon subtype of renal cell carcinoma(RCC),and the diagnosis depends on typical pathological features.Surgical was the main treatment for ChRCC,with less recurrence and metastasis and satisfactory prognosis.