目的　探讨肾癌的临床诊治方法及预后。方法　对本院 1993年 1月～ 2 0 0 1年 12月收治的 2 5 4例肾癌临床资料进行回顾性分析及随访。结果　典型肾癌“三联征”的发生率为 2 .4 % ;肾癌偶发癌占 4 5 .7%。“肾外表现”主要有 :贫血 4 0 .9% ,消瘦 14 .6 % ,发热 12 .6 % ,高血压 10 .2 %。病程 <3个月占 73.6 % ( 187/ 2 5 4 )。辅助检查以B超、CT为主。治疗以肾癌根治术为主 ,占 87.4 % ,术后结合干扰素治疗 ,效果确切。术后 3年、5年生存率分别为 78.7%、72 .9%。预后多因素分析结果表明 ,肾癌的预后与肿瘤分期、直径大小和C erbB2阳性与否相关。结论　临床上无任何表现而体检偶发的肾癌日渐增多 ,典型的肾癌“三联征”已少见。综合分析患者的病史、体检 ,结合辅助检查 ,有助于肾癌的早期诊断 ,适当条件下的健康体检有积极意义。治疗仍以肾癌根治术为主 ,术后免疫治疗有积极的意义。肿瘤分期、直径大小和C erbB2阳性与否对肾癌的预后有提示作用 Objective To investigate the clinical diagnosis and treatment of renal cell carcinoma and its prognosis. Methods The clinical data of 254 cases of renal cell carcinoma admitted to our hospital from January 1993 to December 2001 were retrospectively analyzed and followed up. Results The incidence of “triple sign” of typical renal cancer was 2.4%. Occurrence of renal cell carcinoma was 45.7%. “Renal manifestations” are: anemia 40.9%, weight loss 14.6%, fever 12.6%, hypertension 10.2%. Duration of <3 months accounted for 73.6% (187/245). Auxiliary examination to B-, CT-based. The treatment of radical nephrectomy, accounting for 87.4%, postoperative combined with interferon treatment, the exact effect. After 3 years, the 5-year survival rates were 78.7% and 72.9%, respectively. Prognosis multivariate analysis showed that the prognosis of renal cell carcinoma and tumor stage, diameter and C erbB2 positive or not. Conclusions There is no clinical manifestations of check-up of renal cell carcinoma and an increasing number of typical renal cancer, “Triple Levy” has been rare. A comprehensive analysis of the patient’s medical history, physical examination, combined with laboratory examinations, contribute to the early diagnosis of renal cell carcinoma, healthy conditions under appropriate conditions have a positive meaning. Radiotherapy is still the main treatment of renal cell carcinoma, postoperative immunotherapy has a positive meaning. Tumor stage, diameter and C erbB2 positive or not have a prognostic role in renal cell carcinoma