原发性肾小细胞癌5例临床病理特征及预后因素分析

Clinicopathological features and prognostic factors of primary small cell carcinoma of kidney

目的探讨原发性肾小细胞癌的临床病理学特征及治疗、预后因素分析。方法收集5例原发性肾小细胞癌的临床病理资料,观察组织形态,结合免疫组化进行诊断与鉴别诊断,分析临床分期及治疗方案对预后生存的影响。结果原发性肾小细胞癌患者多以腰腹痛、肉眼血尿为主要首发症状,治疗以行肾输尿管手术切除为主。病理诊断及鉴别诊断需结合病史、组织学及免疫组化;患者中位生存时间为15个月,单因素分析显示影响预后的因素只有临床分期。结论原发性肾小细胞癌是一种罕见的局部侵袭性肿瘤,预后极差,目前尚缺乏规范有限的治疗方案。

Objective To investigate the clinicopathological features,diagnosis,treatment and prognosis factors of primary small cell carcinoma of kidney. Methods The clinicopathological data of 45 cases of primary renal small cell carcinoma reported in our hospital and literature were collected. And the clinical manifestations,histomorphological characteristics,immunohistochemical characteristics,treatment and prognosis were analyzed. The effects of gender,age,tumor site,size,clinical stage and treatment on prognosis and survival were analyzed. Results The patients with primary renal small-cell carcinoma,were mostly treated with lumbago and abdominal pain,gross hematuria as the main initial symptoms,and most of the patients were treated with renal ureterectomy. Pathological diagnosis and differential diagnosis should be combined with history,histology and immunohistochemistry. Median survival time was 15 months. Univariate analysis showed that clinical stage was the only factor affecting prognosis. Conclusion Primary renal small cell carcinoma is a rare locally invasive and fatal tumor. And the prognosis is extremely poor. There are no standardized and limited treatment options.