后肾腺瘤的临床诊治分析

Diagnosis and treatment of metanephric adenoma:a report of eight cases

目的探讨后肾腺瘤的临床诊治方法。方法回顾性分析2013年6月至2019年1月福建省立医院收治的8例后肾腺瘤患者的临床资料,并结合文献复习其临床表现、诊断标准、病理特征、鉴别诊断、治疗及预后等。结果8例患者均行手术治疗,其中6例行保留肾单位肾部分切除,2例行根治性肾切除。术后病理结果均为后肾腺瘤。免疫组化染色显示Vimentin和WT1表达阳性率为100%,CD57表达阳性率为87.5%,CK7局灶表达阳性率为25.0%,CD10、CD56均阴性。随访3~70个月,均未见复发和转移。结论后肾腺瘤的诊断需结合病理学特征和免疫组化染色,保留肾单位手术是其主要治疗措施,其生物学行为不确定,需要长期随访。

Objective To explore the diagnosis and treatment of metanephric adenoma(MA).Methods The clinicopathological data of 8 cases with MA diagnosed and treated in our hospital from June 2013 to January 2019 were retrospectively analyzed,and the clinical manifestations,diagnostic criteria,pathological characteristics,differential diagnosis,treatment options and prognosis of MA were analyzed with literature review.Results All 8 patients underwent surgical treatment,of which 6 underwent partial nephrectomy and 2 underwent radical nephrectomy.Postoperative pathological results were metanephric adenoma.Immunohistochemical study showed that all the cases expressed vimentin and WT1,and 87.5%cases expressed CD57,25.0%CK7,and negative expressions for MA included CD10 and CD56.Eight cases were followed up for 3-70 months,and none of the patients showed any evidence of recurrence and metastasis.Conclusions Pathological features and immunohistochemical staining are required for the diagnosis of metanephric adenoma.The partial nephrectomy surgical treatment is the main treatment measure,its biological behavior is uncertain and requires long-term follow-up.