肾癌术后转移的临床分析

Clinical analysis on the metastasis of kidney carcinoma after operation

目的提高对肾癌术后发生转移的诊治效果。方法回顾性研究137例行肾癌根治术病人,其中随访资料完整的13例转移死亡病历:B超报告13例,肾脏CT报告8例,DSA报告4例;9例行肾癌根治术,4例行肾切除术。结果病理诊断:透明细胞癌9例,乳头状腺癌2例,粒细胞癌2例。转移部位:肺7例,肝1例,骨2例,上腭1例,同侧肾上腺1例,脑1例。术后生存1～12年,平均4.3年。结论肾癌根治术后应长期坚持定期随访和全面、细致的检查,对孤立转移灶应进行积极的手术治疗。

Objective To elevate the effect of diagnosis and treatment for the metastasis of kidney carcinoma after operation.Methods Follow-up survey on 137 patients with kidney carcinoma after radical operation was studied retrospective ly. Among the 13 cases of metastatic death with complete follow-up materials, 1 3 cases were explored by ultrasonic,8 cases by CT on kidneys, 4 cases by DSA.Rad ical operation on kidney carcinoma was performed on 9 cases,nephrectomy was give n to 4 cases.Results Pathological diagnosis showed 9 cases of clear cell carci noma, 2 cases of papillary adenocarcinoma, 2 cases of grahulocyte carcinoma.The location of metastasis showed 7 cases in lung, 1 case in liver, 2 cases in bone, 1 case in upper palate,1 case in ipsilateral adrenal gland, 1 case in brain. The cases survived for 1-12 years after operation,on the average 4.3 years. Conclus ion Long periodic follow-up survey,complete and careful examination should be p ersisted after the radical operation of kidney carcinoma.The operation should be actively performed for the solitary metastasis.