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目的:研究肾集合管癌的临床病理特征及预后。方法:回顾性分析13例肾集合管癌的临床病理资料并进行随访。结果:13例肾集合管癌占同期肾癌0.42%,其中男12例,女1例,平均58(21~81)岁,症状以血尿、腰痛、消瘦为主。CT显示为少血供肿块。12例行肾切除术,1例未手术,肿瘤直径6.1(4.0~8.0)cm,6例淋巴结转移,2例远处转移。TNM临床分期:Ⅰ期3例、Ⅲ期7例、Ⅳ期3例。肿瘤光镜下表现为腺管状或乳头状,部分伴有肉瘤样改变。平均随访26.3(4.0~62.0)个月,1例失访,9例因肿瘤转移或脏器衰竭死亡,3例无瘤生存,中位生存时间为10.7个月,1年生存率41.6%。结论:肾集合管癌是一种罕见的肾癌亚型,病程短,进展快,病理检查是确诊的金标准。目前手术仍是主要治疗手段,化疗和靶向药物等辅助治疗有一定的疗效。肿瘤恶性程度高,预后差,早期诊断和综合治疗可能使患者有更大的获益。
Objective: To investigate the clinicopathological characteristics and prognosis of renal tubulointerstitial cancer. Methods: A retrospective analysis of 13 cases of renal ductal carcinoma of the clinical and pathological data and follow-up. Results: Thirteen patients with renal tubal carcinoma accounted for 0.42% of the patients with renal cell carcinoma in the same period, including 12 males and 1 females, with an average of 58 (21-81) years old. The symptoms were mainly hematuria, lumbago and emaciation. CT showed less blood for lumps. Twelve cases underwent nephrectomy. One case was not operated. The tumor diameter was 6.1 (4.0-8.0 cm). Six cases had lymph node metastasis and two cases had distant metastasis. TNM clinical stage: Ⅰ in 3 cases, Ⅲ in 7 cases, Ⅳ in 3 cases. Tumor under light microscope showed glandular or papillary, some accompanied by sarcomatoid changes. The average follow-up was 26.3 (4.0-62.0) months. One patient was lost to follow-up. Nine patients died of tumor metastasis or organ failure. Three patients had no tumor. The median survival time was 10.7 months and the one-year survival rate was 41.6%. CONCLUSIONS: Renal tubal carcinoma is a rare subtype of renal cell carcinoma with short course, rapid progression and pathological examination. Surgery is still the main treatment, chemotherapy and targeted drugs and other adjuvant therapy have a certain effect. High degree of malignancy, poor prognosis, early diagnosis and comprehensive treatment may make patients have greater benefits.