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目的探讨肾癌的临床特征、诊断及治疗方法。方法回顾性分析116例肾癌患者临床资料。结果本组有症状肾癌46例,体检发现肾癌70例;行肾癌根治术97例、肾部分切除术19例;术后行免疫治疗103例;组织病理确诊透明细胞癌96例,乳头细胞癌8例,嫌色细胞癌5例,多房囊性细胞癌、混合型细胞癌各2例,基因融合型癌、尿路上皮癌、嗜酸性细胞癌各1例;患者中位生存时间为89.8个月,1、3、5a生存率分别为94.8%、76.7%和62.9%;生存期3～5a患者多以透明细胞癌为主,其肿瘤直径<4.9cm,多数无肾外转移,以T1期为主。结论典型“肾癌三联征”非诊断必备条件;腹腔镜下肾癌根治术可取代开放性手术;肿瘤直径小、无肾外转移、TNM分期较低的肾癌患者预后良好。
Objective To investigate the clinical features, diagnosis and treatment of renal cell carcinoma. Methods The clinical data of 116 patients with renal cell carcinoma were retrospectively analyzed. Results The group had 46 cases of renal cell carcinoma, 70 cases of renal cell carcinoma, 97 cases of radical nephrectomy, 19 cases of partial nephrectomy, 103 cases of postoperative immunotherapy, 96 cases of clear cell carcinoma 8 cases of cell carcinoma, 5 cases of chromophobe cell carcinoma, 2 cases of multilocular cell carcinoma, 2 cases of mixed cell carcinoma, 1 case of gene fusion carcinoma, urothelial carcinoma and eosinophilic carcinoma respectively. The median survival time For 89.8 months, the 1,3,5-year survival rates were 94.8%, 76.7% and 62.9%, respectively. Most of the patients with a survival time of 3 ~ 5a were mostly clear-cell carcinoma with a diameter of less than 4.9cm, T1-based. Conclusions The typical “kidney cancer triad” non-diagnostic prerequisites; laparoscopic radical nephrectomy can replace open surgery; small tumor diameter, no renal metastasis, low TNM stage renal cell carcinoma patients with good prognosis.