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目的探讨肾脏恶性肿瘤伴发副肿瘤综合征的临床特点及其与预后的关系。方法回顾性分析北京协和医院2008年1月至2009年12月464例经手术和病理确诊的肾细胞癌患者的临床资料及其随访结果。结果 464例肾细胞癌患者中伴发副肿瘤综合征156例(33.6%),主要临床表现为贫血(26.3%,41/156)、高血压(24.4%,38/156)、发热(21.8%,34/156)、红细胞增多症(19.2%,30/156)、Stauffer综合征(17.3%,27/156)、食欲不振、乏力、体重减轻(15.4%,24/156)、血沉加快(12.8%,20/156)、白细胞增多症(8.3%,13/156)、高钙血症(5.1%,8/156)、糖代谢紊乱(1.9%,3/156)、性激素异常(0.6%,1/156)等。156例伴发副肿瘤综合征患者的肿瘤平均直径为5.5cm,其余患者肿瘤平均直径为4.7cm,两者比较差异有统计学意义(P﹤0.01)。结论肾脏恶性肿瘤副肿瘤综合征的发生率约为33.6%,其出现与肿瘤分期有相关性。
Objective To investigate the clinical features of paraneoplastic syndromes associated with malignant nephropathy and its relationship with prognosis. Methods The clinical data and follow-up results of 464 patients with renal cell carcinoma diagnosed by surgery and pathology from January 2008 to December 2009 in Peking Union Medical College Hospital were analyzed retrospectively. Results A total of 464 patients with renal cell carcinoma (156.6%) had paraneoplastic syndromes. The main clinical manifestations were anemia (26.3%, 41/156), hypertension (24.4%, 38/156), fever (21.8% , 34/156), polycythemia (19.2%, 30/156), Stauffer’s syndrome (17.3%, 27/156), loss of appetite, weakness, weight loss , Hyperglycaemia (5.1%, 8/156), disorders of glucose metabolism (1.9%, 3/156), abnormalities of sex hormones (0.6%, 20/156), leukocytosis 1/156) and so on. The average tumor diameter of the 156 patients with paraneoplastic syndrome was 5.5 cm and the average tumor diameter of the remaining patients was 4.7 cm. The difference was statistically significant (P <0.01). Conclusions The incidence of paraneoplastic syndrome of renal malignant tumors is about 33.6%, which is correlated with the stage of neoplasm.