囊性肾细胞癌患者的临床特征及生存分析研究

目的评估囊性肾细胞癌患者的临床特征并进行生存分析。方法选取SEER数据库中囊性肾细胞癌患者的临床数据, 检索时间为2004年到2019年, 记录患者的临床特征, 并利用Kaplan-Meier法进行生存分析。结果共纳入285例有完整临床资料的患者, 且经组织学均确诊为囊性肾细胞癌, 肾根治性切除术和肾部分切除术是主要的手术类型, 术后发生癌症特异性死亡10例(3.51%)。患者第1、5、10年的癌症特异性生存率分别为99.30%、96.85%、96.49%。结论与常见的肾透明细胞癌相比, 囊性肾细胞癌患者具有更低的临床分期, 更低比例的肿瘤进展和远处转移, 具有良好的预后和极低的疾病特异性死亡率, 但高组织学分级患者可能更容易发生肿瘤进展、复发和癌症特异性死亡, 建议接受更积极的治疗和监测。     

肾细胞癌的治疗近展

肾细胞癌为肾脏实质上皮性的恶性肿瘤,是最常见的肾脏癌瘤,国内统计占各种癌的0.4-0.7%,国外文献报告肾细胞癌占肾肿瘤的75-85%,在男性中占所有癌的2.1%,在女性中占所有癌的1.3%。近几年来肾细胞癌的发病数有明显增高趋势,加之其临床情况复杂,早期诊断困难,预后较差,故向为泌尿外科医师所重视。现对近来肾细胞癌治疗方面的进展作一综述,以供参考。外科疗法虽然恶性肾肿瘤早在1826年就被描述过,而今治疗方法较多,但疗效均不满意,目前最根本的疗法仍以外科手术切除为主。其术式多采用根治性肾切除。其概念是尽早控制肾血管蒡,将患肾连同肾周围     

肾癌合并下腔静脉瘤栓患者围手术期护理对策

肾细胞癌是一种主要起源于近端小管的腺癌,约占所有原发肾脏恶性肿瘤的85%,其他肾癌大多数为肾盂尿路细胞癌[1]。近三十年来,随着医学影像学技术的进步,肾细胞癌的发病率呈上升的趋势[2],虽然由此发现的肾癌患者多为局部病变,但呈侵入性生长及发生远处转移的癌症发病率也在上升[3]。肾细胞癌倾向于形成瘤栓并延伸到肾脏以     

乳头状肾细胞癌10例临床分析

乳头状肾细胞癌是较少见的肾细胞癌，1997年国际抗癌联盟(UICC)和美国癌症联合委员会(AJCC)正式将其归类为肾癌的4种基本形式之一，约占肾癌的10％～15％，居第2位。我院自1985年至2003年共收治10例乳头状肾细胞癌病例，现报告如下。     

晚期肾透明细胞癌一线靶向治疗的优化选择中国专家共识（2022）

<正>肾细胞癌简称肾癌(renal cell carcinoma, RCC)是起源于肾小管上皮的恶性肿瘤，约占肾脏恶性肿瘤的90%,其中最常见的组织类型为肾透明细胞癌(clear cell renal cell carcinoma, ccRCC)[1]。临床使用最广泛的RCC分期系统是美国癌症分期联合委员会(American Joint Committee on Cancer Staging, AJCC)制定的TNM分期系统。     

儿童和青少年Xpl1．2易位／TFE3融合基因肾细胞癌的研究进展

儿童和青少年肾细胞癌最常见的类型是Xpll．2易位／TFE3融合基因肾细胞癌,约占总病例数的1／3,其主要特点是基因组具有Xpll．2位点的易位。该类肾细胞癌在2004年WHO泌尿及男性生殖系统肿瘤分类中首次被单独归为一类,但关于其临床病程和生物学行为等方面仍然存在很多未知。作者将对儿童和青少年Xpll．2易位／TFE3融合基因肾细胞癌的研究进展做一综述。     

肾原发性大细胞神经内分泌癌1例报告并文献复习

目的提高对肾神经内分泌癌的认识。方法报告1例肾原发性大细胞神经内分泌癌的临床资料并结合文献讨论有关临床症状、诊断和治疗。结果肾神经内分泌癌临床表现和影像学与常见。肾癌相比无明显特异性,需通过病理学和免疫组织化学结果肯定诊断。结论肾原发性大细胞神经内分泌癌罕见,其临床和影响学表现难与肾癌区别,主要靠病理学和免疫组织化学确诊,该病恶性程度高、预后差,只有早期发现,早期手术治疗以提高疗效。     

胰腺转移癌手术治疗的安全性和有效性

胰腺转移癌较为罕见，且关于其相关治疗措施的研究很少。为评价胰腺切除术的安全性和有效性，Niess H等回顾性分析了1991～2010年期间接受胰腺转移癌切除手术的26例患者的临床资料。其中11例行胰头切除，14例行胰尾切除，1例行全胰腺切除。他们发现，肾细胞癌、胆囊癌、结肠癌及平滑肌肉瘤是导致胰腺转移癌的主要原因，其中以肾细胞癌最常见。     

肾嫌色细胞癌侵入肾盂一例分析及文献复习

肾盂癌和肾细胞癌是泌尿外科常见的肿瘤性疾病,两者的治疗方案及预后迥异。当肾细胞癌侵犯肾盂时,会对临床判断造成困难。术前判断肿瘤性质对临床工作有重要意义。肾细胞癌有多种亚型,肾嫌色细胞癌是其中相对少见的亚型之一,且肾嫌色细胞癌侵犯肾盂的案例国内外尚无文献总结。本文介绍一例收治于北京协和医院泌尿外科的肾嫌色细胞癌患者,肿瘤侵犯肾盂,临床表现及影像学特征模拟肾盂癌。现将病例资料总结如下并作文献回顾。     

HIF-2与肾细胞癌研究进展

近来新发现的缺氧诱导因子2(hypoxia inducib le factor 2,HIF-2),其作用与肾细胞癌有密切关系,目前研究显示其在肾细胞癌发病过程中起重要的作用。本文就目前国外对缺氧诱导因子2与肾细胞癌关系的研究进行综述。     

Renal cell carcinoma with widespread metastasis in 19 years old young male – A rare case report

Introduction and importanceRenal cell carcinoma is the most common malignant tumor of the kidney which occurs more frequently in men and older people than in women and young adults. Renal cell carcinoma is the second most common renal malignancy diagnosed among pediatric and adolescent patients comprising of 2% to 6% of renal cancers.Case presentationA 19 years old young adult male came with a history of epigastric and back pain, hematuria and weight loss. Per abdominal examination showed a palpable mass in the epigastric and left hypochondriac region. Radiological imaging showed diffuse infiltration of renal interstitium with multiple hypodense lesions in left kidney, renal vein infiltration, and lytic destruction of vertebral bodies and left superior pubic ramus. Fine needle aspiration cytology and trucut biopsy was taken which confirmed renal cell carcinoma, clear cell type with bone metastasis.Clinical discussionAlthough most renal cell carcinoma is sporadic and relatively uncommon in young adults, the incidence of renal cell carcinoma in this age group has steadily increased. Young adults are less likely to receive diagnosis of renal cell carcinoma incidentally. A few reported pediatric series have shown that renal cell carcinoma is highly aggressive, tends to be invasive, and metastasizes to the lungs and bones.ConclusionYoung adult with clear cell renal cell carcinoma showing wide spread metastasis is rare. Since, young age is an independent prognostic factor for cancer-specific survival, early diagnosis of the tumor will be beneficial for patients.     

Epidemiology,Aetiology, and Pathogenesis of Renal Cell Carcinoma

Significant advances in molecular medicine have made renal cell carcinoma (RCC) the prototype solid organ malignancy for targeted medical cancer treatment. Theseis new options have made it possible to prolong the life of patients with metastatic disease. However, we are far away from thoroughly understanding the molecular processes of RCC development let alone from being able to cure advanced renal cancer. RCC is the most common renal neoplasia and it remains a very aggressive and often fatal disease.There are several known histologic subtypes of this heterogeneous tumor entity with associated distinct molecular alterations and different clinical outcomes [1], [2], [3], [4]. The clear cell renal cell carcinoma (ccRCC) is the most common and apparently most aggressive RCC subtype with the highest rates of local invasion, metastasis and mortality. It constitutes 70–80% of all renal cancers [1], [5]. It is estimated that more than 30% of patients with RCC have metastatic disease at the time of diagnosis and 30% of organ-confined RCCs will develop metastatic disease after local treatment [6]. Thus, RCC remains a very major challenge.     

Solitary Pancreatic Metastasis from Renal Cell Carcinoma Concomitant with Early Gastric Cancer 17 Years After Nephrectomy: Report of a Case

The pancreas is an uncommon site for metastasis from renal cell carcinoma. We report the case of a 70-year-old man in whom a solitary pancreatic metastasis from renal cell carcinoma, found 17 years after nephrectomy, was successfully resected, combined with gastrectomy for early gastric cancer. We also discuss the relevant literature, including all the reports of pancreatic metastasis from renal cell carcinoma found in Medline. More than half the cases, like ours, were asymptomatic. A good prognosis can be expected once the pancreatic metastatic lesions are surgically excised, especially if it is a solitary metastasis. Therefore, surgical resection of pancreatic metastases is recommended to achieve the best chance of long-term survival. Special attention must be paid to the possibility of recurrence, even more than 10 years after nephrectomy for renal cell carcinoma, and imaging modalities should be part of the routine follow-up to detect metastases at an early stage.     

An unusual case of Von Hipple Lindau (VHL) syndrome with bilateral mutlicentric renal cell carcinoma with synchronous solitary urinary bladder metastasis

In VHL syndrome, renal cell carcinoma is distinctive for its early age of onset, for its bilateral and multifocal involvement. Synchronous solitary urinary bladder metastasis from renal cell carcinoma is extremely rare. We report an unusual case of VHL with bilateral multicentric renal cell carcinoma and synchronous solitary urinary bladder metastasis. To the best of our knowledge this is the first case reported in literature with this combination.     

Stauffer's syndrome--diagnostic help in hypernephroma.

Dysfunctions of the liver known as Stauffer's syndrome have been observed in various cases of renal cell carcinoma. In a case history of renal cell carcinoma the most common clinical symptoms and laboratory findings of early presentation are displayed. During the first clinical investigations the evidence of typical laboratory values indicating unusual hepatic dysfunction, did not lead to the true diagnosis until symptoms became clearer two year later. Intensified renal diagnosis are asked for in any case of unexplained abnormalities of liver function in order to exclude a renal cell carcinoma or to force its early diagnosis.     

Impact of caveolin-1 expression on clinicopathological parameters in renal cell carcinoma

PURPOSE: Caveolin-1 is a major structural component of caveolae, which are plasma membrane microdomains implicated in the regulation of intracellular signaling pathways. Previous studies of the expression and function of caveolin-1 in cancer have shown controversial results, indicating that the physiological role of caveolin-1 varies according to cancer type. We evaluated caveolin-1 expression in renal cell carcinoma and investigated its association with pathological features and clinical outcome. MATERIALS AND METHODS: Caveolin-1 expression was evaluated by immunohistochemistry using rabbit polyclonal antibody against caveolin-1 in 60 paraffin embedded primary renal cell carcinoma specimens and 6 metastatic renal cell carcinoma specimens. When more than 50% of all cancer cell cytoplasm stained, the tumor was considered caveolin-1 positive. Associations between caveolin-1 expression, and pathological features and clinical outcomes were analyzed. RESULTS: Of 60 primary tumors 16 (26.7%) and 5 of 6 metastatic tumors (83.3%) were immunoreactive in more than 50% of cancer cells and considered caveolin-1 positive. Although no significant associations between caveolin-1 expression, pathological stage (T stage) and distant metastasis at initial presentation were observed, significant associations between positive caveolin-1 expression and high grade tumor (p = 0.0009) and regional lymph node metastasis at initial presentation (p = 0.0049) and venous invasion (p = 0.0195) were observed. There was no difference in cancer specific survival between caveolin-1 positive and negative groups. However, in 43 patients without metastasis to regional lymph nodes or a distant site at initial presentation (N0M0) the caveolin-1 positive group had significantly shorter progression-free survival than the caveolin-1 negative group (p = 0.0332). CONCLUSIONS: Caveolin-1 over expression could be a common finding in aggressive forms of renal cell carcinoma. Caveolin-1 might have an important role in the invasion and metastatic progression of renal cell carcinoma.     

Parotid gland metastasis from renal carcinoma

The salivary gland most frequently involved with secondary cancer is the parotid gland. Metastases are responsible for 21-42% of malignant parotid tumors. Malignant melanoma and squamous cell cancer are the two most common tumors to metastasize to the parotid gland. Metastatic adenocarcinoma to this site has rarely been reported. Secondary renal cell carcinoma has been reported in many structures, including the brain, sinonasal tract, lungs, abdomen, genitourinary tract, bone, soft tissue, and lymphatics. Histologically proven parotid metastasis has been previously reported in only one patient. Two patients have recently been diagnosed and treated at our institution for this rare disease. The clinical presentation of each patient was quite different. One patient presented with parotid and pulmonary metastases seven years after resection of a renal tumor. Another patient had resection of a parotid mass revealing an occult metastasis from a renal cell carcinoma. Further evaluation revealed a locally extensive asymptomatic hypernephroma. The survival from the time of discovery of the parotid metastasis was 46 months for the former patient, while the latter patient is alive after 20 months. Differentiation of these tumors from vascular disorders (aneurysm or arteriovenous fistula) required selective angiography and computed tomography. Surgical excision via superficial parotidectomy with facial nerve preservation is necessary for palliation, particularly to avoid massive hemorrhage which may occur upon tumor extension into the oropharynx.     

紧密连接蛋白ZO-1在肾癌中的表达及其临床意义

目的 探讨闭锁小带蛋白(sonula occluden-1,ZO-1)这种紧密连接相关蛋白在肾癌中的表达情况及其临床意义。方法 采用免疫组织化学法检测55例肾癌患者手术切除的肾脏病理标本中正常肾组织以及肾癌组织中ZO-1蛋白的表达,并分析肾癌组织中ZO-1的表达与肿瘤的侵袭和转移之间的关系。结果 ZO-1蛋白在正常肾组织和肾癌组织中的阳性表达率分别为74.5%和32.7%。 两组间进行比较显示,ZO-1蛋白在肾癌组织中的表达水平明显低于正常肾组织,组间具有差异性（P<0.05）。在肾癌组织中,ZO-1蛋白的表达水平与癌组织的临床分期、分化程度以及淋巴结转移有关。结论 人肾癌组织中ZO-1蛋白的表达较正常肾组织减少,并且其可能参与肾癌肿瘤细胞的侵袭和转移。     

Intraocular metastatic renal carcinoma presenting as progressive unilateral blindness

Clear cell renal carcinoma is the most common histological type, representing 70-80% of all renal carcinomas. Metastases are already present in about 25-30% of patients at the time of diagnosis of renal cell carcinoma. Ocular metastasis is extremely rare.     

A Case of Prostate Carcinoma Metastasizing to Renal Cell Carcinoma

Metastasis of one cancer to another cancer is extremely rare. The most frequent metastisizing tumor is a king carcinoma, and the most common recipient tumor is a renal cell carcinoma. We report herein a case of prostate carcinoma metastasizing to a renal cell carcinoma, which has previously been reported only four times.