肾原发性神经内分泌癌诊治分析(附10例报告)

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摘要目的:探讨肾原发性神经内分泌癌(NECK)的临床病理特点,提高对该疾病的诊治水平。方法:回顾分析2000年1月~2015年11月期间诊治的10例病理诊断为NECK患者的临床病理资料。归纳总结该类肿瘤的临床特点、病理学特点、诊疗手段及临床预后。结果:10例患者病理诊断均为NECK,其中男2例,女8例,平均年龄40.1(22~70)岁。左肾2例,右肾8例。肿瘤最大径平均7.35(2.5~21.0)cm。TNM分期:T₁N₀M₀ 2例,T₂N₀M₀ 3例,T₃N₀M₀ 4例,T₃N₁M₀ 1例。10例患者均行手术治疗。平均随访21.2(1~75)个月,1例失访,2例患者术后发生远处转移,2例死亡。结论:NECK临床罕见,诊断依赖病理组织学及免疫组化检查,治疗以手术为主,辅以化疗,其中类癌恶性度较低,预后相对较好,其余类型恶性度高,发展迅速,预后较差。

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关键词 ：肾肿瘤, 肾原发性神经内分泌癌, 诊断, 治疗

Abstract：To investigate the clinicopathological features of neuroendocrine carcinoma of the kidney (NECK). Methods: The clinicopathological data of 10 patients NECK treated from January 2000 to December 2015 were analyzed retrospectively, and clinical manifestations, characteristics of immunohistochemistry, diagnosis, treatment and prognosis were summarized. Results: The mean age of all patients at diagnosis was 41 years-old (22-70 years), including 2 males and 8 females. The tumor of 2 patients was localized in the left side, and that of the rest in the right side. The average maximum diameter of tumors was 7.35 cm. The TNM stage of 2 patients was T₁N₀M₀, 3 T₂N₀M₀, 4 T₃N₀M₀ and one T₃N₁M₀. All of the 10 patients received nephrectomy successfully. The mean follow-up period was 21.2 months with one patient lost to follow-up. Two patients were alive with metastasis in liver or lung. Two patients died 4 months after surgery. Conclusions: NECK is a rare histological type of renal cell carcinoma. Pathological examination is the gold standard for the diagnosis of NECK. The treatments of NECK include surgery, chemotherapy and targeted therapy. Renal carcinoid tumors are indolent and associated with prolonged survival, while the other types of NECK are aggressive tumors with relatively short overall survival.

Key words： renal neoplasms neuroendocrine carcinoma of the kidney diagnosis treatment

收稿日期: 2016-02-06

ZTFLH:

R737.11

基金资助:国家重点基础研究发展计划(973计划)(2013CB530803)

通讯作者: 张旭,xzhang@foxmail.com

引用本文:

武翀，马明辉，赵超飞，王雷，刘侃，孟庆禹，姚远新，罗国雄，郭爱桃，张旭. 肾原发性神经内分泌癌诊治分析(附10例报告)[J]. 微创泌尿外科杂志, 2016, 5(2): 112-115.
Wu,Chong,Ma,Minghui,Zhao,Chaofei,Wang,Lei,Liu,KanMeng,Qingyu,Yao,Yuanxin,Luo,Guoxiong,Guo,Aitao,Zhang,Xu. Diagnosis and treatment of neuroendocrine carcinoma of the kidney (Report of 10 cases). JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2016, 5(2): 112-115.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1144.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2016/V5/I2/112

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