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目的 探讨小肾癌 (SRCC)的临床症状、影像学特征、分级分期与预后的关系。 方法 选择直径≤ 3cm的小肾癌患者 76例。其中有血尿、腰痛的 17例计为症状组 (2 2 .4 % ) ,健康体检或因其它疾患就诊偶然发现的 5 9例 (77.6 % )计为无症状组。 6 9例行B超检查 ,诊断率 84 .1% ;76例行CT检查 ,诊断率 94 .7%。 结果 76例患者均行经腰部斜切口根治性肾切除术 ,病理诊断均为透明细胞癌。术后随访 32～ 87个月 ,平均 6 2 .7个月。症状组和无症状组术后 1、3、5年无瘤生存率分别为 10 0 .0 %、5 3.3%、33.3%和 10 0 .0 %、90 .6 %、77.4 % ,两组 3年和 5年生存率差异均有显著性意义 (P <0 .0 5 )。 结论 小肾癌的早期诊断主要依赖B超和 (或 )CT等影像学检查。无症状患者的远期无瘤生存率显著高于有症状患者。
Objective To investigate the clinical manifestations, imaging features, grading and prognosis of small renal cell carcinoma (SRCC). Methods 76 cases of small renal cell carcinoma with diameter less than 3 cm were selected. Among them, 17 cases with hematuria and back pain were classified as symptom group (22.4%), and 59 cases (77.6%) were found asymptomatic group by physical examination or accidental finding of other diseases. 6 9 routine B-ultrasound, the diagnostic rate of 84.1%; 76 routine CT examination, the diagnostic rate of 94.7%. Results 76 patients underwent radical nephrectomy by oblique incision. The pathological diagnosis was clear cell carcinoma. The patients were followed up for 32 to 87 months with an average of 62.7 months. The 1, 3 and 5-year postoperative tumor-free survival rates in patients with symptoms and asymptomatic groups were 100.0%, 53.3%, 33.3% and 100.0%, 90.6% and 77.4%, respectively Year and 5-year survival rates were significantly different (P <0. 05). Conclusion Early diagnosis of small renal cell carcinoma mainly depends on the imaging examination such as B-mode ultrasound and / or CT. Asymptomatic patients with long-term disease-free survival was significantly higher than the symptomatic patients.