32例乳头状肾细胞癌临床诊治分析

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摘要 目的:分析总结乳头状肾细胞癌的临床特点。方法:回顾分析2008~2012年术后病理诊断为乳头状肾细胞癌的临床资料。结果:5年间乳头状肾细胞癌共32例,占同期肾细胞癌5.99%。其中男27例,女5例,年龄54.5(37~74)岁。就诊时10例腰痛,7例出现肉眼血尿,2例出现腰痛伴血尿,余无明显症状。25例行后腹腔镜手术,7例行开放手术治疗,两组手术时间无显著区别,但腹腔镜组平均术中出血量显著低于开放手术组。肿瘤平均最大径为5.1 cm。T_1aN₀M₀ 12例,T_1bN₀M₀ 15例,T_2aN₀M₀ 3例,T_1bN₁M₀ 1例,T_3aN₀M₁ 1例。24例获随访,随访时间9~46个月,均无瘤生存。结论:乳头状肾细胞癌好发于男性,与肾透明细胞癌对比,在临床表现上无明显差异,但影像学表现、病理形态及临床转归有所不同。根治性肾切除术是目前首选治疗方式,腹腔镜手术与开放手术治疗效果相似,微创优势显著。本病预后较好。

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	刘旮
	傅龙龙
	余月
	王义兵
	傅斌
	王共先

关键词 ：肾细胞癌, 乳头状肾细胞癌, 治疗, 手术

Abstract：Objective:To investigate the clinical features of papillary renal cell carcinoma (PRCC). Methods:Retrospective analysis of the clinical data of patients with PRCC in our hospital from 2008 to 2012. Results:There are 32 patients confirmed as PRCC by post-operative pathology, which account for 5.99% of all patients with renal cell carcinomas in the five years. 27 patients are male, 5 patients are female. The mean age was 54.5 years (ranged from 37 to 74).10 patients presented with lumbago, 7 with gross hematuria, 2 with both lumbago and hematuria, the rest are. 25 patients were treated with laparoscopic surgery and 7 were treated with open surgery, with the similar mean operative time. The mean operative blood loss is significant less in laparoscopic surgery group than in the open surgery group. The average maximum diameter of tumors was 5.1 cm. TNM stage :T_1aN₀M₀ in 12 patients,T_1bN₀M₀ in 15,T_2aN₀M₀ in 3,T_1bN₁M₀ in 1, and T_3aN₀M₁ in 1. 24 patients were followed up for 9-46 months. All of them survived without tumor recurrent. Conclusions:Papillary renal cell carcinoma has similar clinical features with renal clear cell carcinoma, but it has special imaging and pathological characteristics,and a better prognosis. The gold treatment of PRCC is radical nephrectomy. The laparoscopic surgery has similar treatment efficacy to open surgery, but with significant micro-invasive advantages.

Key words： renal cell carcinoma papillary renal cell carcinoma therapy operation

收稿日期: 2013-09-06

ZTFLH:

R737.12

基金资助:863计划项目资助项目(2012AA021104)

通讯作者: 王共先,wanggx-mr@126.com

引用本文:

刘旮, 傅龙龙, 余月, 王义兵, 傅斌, 王共先. 32例乳头状肾细胞癌临床诊治分析[J]. 微创泌尿外科杂志, 2013, 2(5): 328-330.
Liu Ga, Fu Longlong, Yu Yue, Wang Yibin, Fu Bin, Wang Gongxian. The clinical analysis of 32 patients with papillary renal cell carcinoma. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2013, 2(5): 328-330.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1061.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2013/V2/I5/328

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