微软用户 第三军医大学学报.doc

原发性肾盂鳞状细胞癌诊治及预后分析（附4例报告） 1刘耀雷 2贾占奎 2杨锦建 3秦书娟 【摘要】目的 探讨原发性肾盂鳞状细胞癌的诊断、治疗和预后。方法 回顾性分析2008年至2012年间收治4例原发性肾盂鳞状细胞癌患者的临床资料。临床表现腰部疼痛3例，左下腹疼痛1例，肉眼血尿3例，镜下血尿1例， 4例均并发患侧肾结石；IVU检查1例，CT检查4例；3例肿块直径5cm， 4例术前均诊断为肾盂癌，其中左肾3例，右肾1例；均行肾盂癌根治性切除术。结果 4例病理诊断均为肾盂鳞状细胞癌，高分化1例，中分化2例，中-低分化1例，区域淋巴结转移3例，Ⅱ期1例，Ⅳ期3例。1年内死亡2例（其中1例术后3个月出现左侧肋骨浸润，行化疗），1例术后存活至今5个月，1例失访。结论 原发性肾盂鳞癌术前诊断困难，恶性程度高，预后差，临床上对结石病史长、腰部慢性疼痛和血尿的患者应给予重视。 【关键词】肾盂鳞状细胞癌；肾脏恶性肿瘤；肾结石 Analysis of the diagnosis, the therapy and prognosis of primary squamous c- ell carcinoma of renal pelvis (report of 4 cases) LIU Yao-lei,, JA zhan- kui , TANG Xiao-long, YANG Jin-jian QIN Shu-juan Department of Urology, The Fir st Aff iliated Hospital of Zheng Zhou University, Zhengzhou, 450052, China Corresponding author: YANG Jin-jian, Email: zzdxyfyyjj@126.com [Abstract] Objective to explore the clinical feature, the diagnosis and therapy method, the prognosis of primary squamous cell carcinoma of renal pelvis. Method Retrospective analysis of the clinical records of four patients who were diagnosed with squamous cell carcinoma of renal pelvis between 2008 and 2012 was performed in our hospital. The symptoms of the patients were renal area pain (three cases), abdominal pain (one case), hematuria (four cases). All patients suffered from calculi of the affected kindey at the same time. One patient underwent IVP examination and four patients underwent CT scan. The diameter of the masses in three patients were more than 5 cm. All patients were diagnosed as renal pelvis carcinoma before operation. 3 left kindey and 1 right kindey. Result the pathologic examination showed that all patients were squamous cell carcinoma. Histological classification suggested that two cases were moderately differentiated, one case was well differentiated , one case was moderately-poorly differentiated. Three cases had lymph nodes metastasis. Three cases had stage Ⅳ and one case had stage Ⅱ. Two cases died within one year, one case still survived 5 months after operation. One case los