囊性肾细胞癌的诊治分析

目的:分析并探讨囊性肾细胞癌的临床特点、诊断及治疗方法，提高囊性肾细胞癌的诊治水平。 方法:回顾性分析60例囊性肾细胞癌患者的临床资料及随访结果。 结果:44例行根治性肾切除术，15例行肾部分切除术，1例行单纯性肾切除术。术后病理结果:多房囊性肾细胞癌18例，囊性坏死肾细胞癌25例，单房囊性肾细胞癌11例，单纯囊肿恶性变6例。56例获随访，平均随访52个月(6~100个月) ,1例尿毒症患者术后15个月死于肾衰竭；余患者随访期内均未见局部复发或远处转移。结论:囊性肾细胞癌无特征性临床表现，诊断主要依靠影像学检查，术前诊断困难者可术中快速冰冻病理检查。囊性肾细胞癌预后较好，治疗应争取行保留肾单位手术。

Diagnosis and treatment of cystic renal cell carcinoma

Objective: To analyze the clinical features of cystic renal cell carcinoma (CRCC) and improve the diagnosis and treatment of CRCC. Method: The clinical data of 60 cases with CRCC was analyzed retrospectively. The clinical presentation, radiologic features, surgical procedure, pathologic features as well as follow-up outcomes of the CRCC were studied. Results: The diagnosis of CRCC was confirmed by postoperative pathology. Histopathologic examination demonstrated multilocular cystic renal cell carcinoma in 18 cases, renal cell carcinoma degeneration in 25 cases, unilocular cystic renal cell carcinoma in 11 cases, and preexisting simple cyst cancerization in 6 cases. Fifty six cases were followed. The mean follow-up period was 52 months (ranging from 6 to 100 months). one case of uremia died from renal failture 15 months after surgery. The remaining cases were tumor-free during the follow-up period. Conclusion: Most of CRCC can be diagnosed with B ultrasonography and CT scan. Rapid frozen section analysis contributes to the pathological diagnosis for the uncertain cases and reduces the ratio of misdiagnosis. The prognosis of CRCC is accurate and nephron-sparing surgery is recommended.