肾嫌色细胞癌21例临床分析及文献复习

目的 提高肾嫌色细胞癌的诊治水平和对此类型肾癌的认识.方法 回顾性分析21例肾嫌色细胞癌的临床资料.男11例,女10例.年龄27 ～ 85岁,平均52岁.11例行腹腔镜下肾癌根治术,8例行腹腔镜下肾部分切除术,2例行开放肾癌根治术.结果 术后病理证实为肾嫌色细胞癌.病理分期:pT1N0M0 13例,pT2N0M0 5例,pT3aN1 M0 2例,pT4N0M0 1例.Fuhrman病理分级:G1 6例,G2 14例,G31例.术后随访19例,时间3～36个月,平均17个月,1例死于心脏病,1例术后6个月局部复发,给予索拉非尼治疗2个月后肺部感染死亡,1例术后12个月后出现肺转移,给予索拉非尼治疗1个月后死亡,16例无瘤生存.结论 肾嫌色细胞癌是一种具有特殊形态的少见肾癌类型.肾根治性切除术是治疗肾嫌色细胞癌的首选方法.与同期、同级的其他类型肾癌相比,肾嫌色细胞癌预后较好.

Renal chromophobe cell carcinoma: clinical analysis and review of 21 cases

Objectives To improve the diagnosis level of renal chromophobe cell carcinoma (RCCC) and the recognition of renal cell carcinoma (RCC).Methods The clinical data of 21 patients with RCCC (11 men and 10 women) were analyzed.Their age ranged from 27 to 85 years,with a mean of 52 years.11 cases underwent retroperitoneal laparoscopic radical nephrectomy,8 cases underwent laparoscopic partial nephrectomy and 2 cases underwent open radical nephrectomy.Results Postoperative pathological findings confirmed the diagnosis of RCCC.The pathologic TNM stage of RCCC was as follows:pT1N0M0 in 13 cases,pT2N0M0 in 5 cases,pT3aN1M0 in 2 cases and pT4N0M0 in 1 case.The Furhman pathologic grade of RCCC was G1 in 6 cases,G2 in 14 cases and G3 in 1 case.Nineteenth cases were followed up.During the follow-up of 3 to 36 months(mean 17 months).One case died of heart attack,one case had local recurrence and died of pulmonary infection,one case died of pulmonary metastasis of carcinoma and 16 cases were surviving tumor free.Conclusions RCCC is a morphologically distinctive uncommon type of RCC.Radical nephrectomy is the first choice for the treatment of RCCC.Compared with other types of RCC at the same stage and of the same grade,RCCC has a better prognosis.