450例肾细胞癌的临床回顾分析

目的:探讨肾细胞癌的临床特征、预后因素及诊治情况。方法:回顾性分析1999年1月-2005年1月期间收治的450例肾细胞癌患者临床特征、诊疗方法和预后情况。结果:450例平均年龄54.2岁。术后病理检查提示透明细胞癌375例,颗粒细胞癌40例,其他类型肾细胞癌35例。临床分期为T1N0M0期267例,T2N0M0期142例,T3期以上(含T3期)41例,其中偶发肾癌263例,有症状肾癌187例。行肾癌根治性切除术372例,保留肾单位手术78例,其中静脉癌栓取出术8例,术后行α-干扰素治疗161例。平均随访时间37个月(4-60个月)。结论:B超、CT是目前早期诊断肾癌的重要手段;早期行根治性肾切除术仍是最有效的治疗方法,保留肾单位的肾部分切除术对局限性小肾癌是一项可供选择的手术方法,尤其适合于对侧并发肾脏疾病的患者;联合生物治疗对肾细胞癌晚期患者有一定效果。

A retrospective study of 450 cases of renal cell carcinoma

Objective:To study the correlation of clinical characteristic,prognosis,diagnosis and treatment of renal cell carcinoma.Methods:450 cases of renal cell carcinoma were reviewed for their incidence,diagnosis,treatment and prognosis.A retrospective analysis was made to reveal the correction of clinical characteristic,diagnosis,treatment and prognosis of 450 cases of renal cell carcinoma.Results:450 cases of patients,male(287cases),female(163 cases),the average age is 54.2 and among which 375 cases were clear cell carcinoma,40 cases were granular cell carcinoma,35 cases were other cell types,263 cases were incidentaloma,and 187 cases were symptomatic.372 cases were accepted the Radical nephrectomy,78 cases were accepted the Nephron sparing surgery(NSS).Radical nephrectomy plus tumor thrombus removing guarantee was performed for 8 cases,161 cases were treated with the medicine of Interferon,then 356 cases were followed up and 57 cases died.Conclusions:B type ultrasonography and computerized tomography are important measures in the early diagnosis of renal cell carcinoma.In early stage,the most effective treatment is radical nephrectomy.Nephron sparing surgery is an available method for renal cell carcinoma patients with small,localized tumors,especially fit for the patients with renal cell carcinoma.The therapy combined with Interferon is certain effect to the patients of advanced stage renal cell carcinoma.