多房囊性肾细胞癌的诊断和治疗.docxVIP

多房囊性肾细胞癌的诊断和治疗 湖南省衡阳市南华大学附属第二医院湖南衡阳421001 【摘 要】目的提高多房囊性肾细胞癌(MCRCC)的诊治水平和对此 类型肾癌的认识。方法回顾性分析7例MCRCC的临床资料。男5例，女2例。 年龄41?70岁，平均57.2岁。4例行根治性肾切除术；1例行肾部分切除术；1 例误诊为多房性肾囊肿，行肾部分切除术；1例术中冰冻结果MCRCC,行根治性 肾切除。结果7例术后病理证实均为MCRCCo Fuhrman核分级I级5例，II级2 例。肿瘤TNM分期:T1N0M05例，T2N0M02例。7例获随访8个月?6年,平 均27个月。1例死于心肌梗死，6例目前无瘤生存。结论MCRCC是肾癌的一种 特殊类型，多为偶发癌，病理分级分期低，手术治疗效果满意，预后佳。临床可 以考虑实施保留肾单位手术。 【关键词】肾肿瘤，多房囊性肾细胞癌；病理学；诊断；治疗 Abstract： [Objective] To improve the diagnosis and treatment of multilocular cystic renal cell carci noma (MCRCC) and the recog nition of this subtype of renal cell carcinoma (RCC) . [Methods】The clinical data of 7 cases of MCRCC (5 men and 2 women) were analyzed.Their age ranged from 41 to 70 years (mean 57.2) .Of the 7 cases, 4 un derwe nt radical n ephrectomy a nd 1 un derwe nt partial nephrectomy. 1 was misdiagnosed multilocular renal cyst and underwent partial n ephrectomy.l were in tra ? operatively con firmed by froze n secti on of samples and underwent radical nephrectomy.【Results] Postoperative pathological findings con firmed the diag nosis of MCRCC.Fuhrma n Grade I in 5 cases and Grade II in 2.The pathological staging showed T1N0M0 in 5 cases and T2N0M0 in 2.5 patients were followed up for 8 mon ths to 6 years (mea n 27 mon ths)? 1 case died of myocardial infarct io n, the others survived with no evide nee of can cer now.【Con clusi on 】MCRCC represents a distinet subtype of RCC」t is usually with low grade, low stage and is found in cide ntally.MCRCC can be cured by surgery and the prog nosis is favorable.Nephron-sparing surgery should be considered in suitable cases. Key words： Kidney neoplasm； multilocular cystic renal cell carci no ma； Pathology； Diagnosis； therapy 2004年泌尿和男性生殖系统WHO分类⑴将多房囊性肾细胞癌 （Multilocular cystic renal cell carcinoma, MCRCC）定为与肾透明细胞癌并列的一 种肾细胞癌的独立亚型。我院2004年6月至2015年6月病理诊断多房囊性肾细 胞癌7例，占同期收治肾癌的0.85% （7/825）o现报告如下： 1资料和方法 本组7例。男5例，女2例。年龄41?70岁，平均57.2岁。左肾4例， 右肾3例° 2例腰部酸胀不适，5例查体发现肾占位病变，无明显症状。病程10d? 6个月。 7例均行B超及CT检查。肿瘤直径2?10cm,平均5.5cm。上极4例, 中部1例，下极2例。B超显示6例为囊