摘要
目的:探讨肾集合管癌(Collecting duct carcinoma,CDC)的临床特点及预后,以提高对CDC的诊治水平。方法:回顾性研究4例CDC患者的临床特点及病理资料并进行随访。结果:4例CDC患者占同期肾癌的1.41%,全部为男性,年龄为51～62岁。主要症状为血尿、腰腹痛、乏力、消瘦及低热。其中1例术前诊断为肾结核,但术中探查发现合并输尿管多发结节,冷冻切片病理检查为输尿管癌,行患侧肾癌根治性切除加输尿管全长及膀胱部分切除术,术后病理检查为CDC并输尿管移行细胞癌。2例术前发现双肺多发转移病灶,同时肾门、肾动脉与腹主动脉间多发肿大淋巴结,术中尽量切除可疑淋巴结,术后病理检查证实为淋巴结转移。另1例术后病理检查报告为CDC,部分为透明细胞癌。肿瘤TNM分期:2例为T2N2M1(Ⅳ期),1例为T2aN0M0(Ⅲ期),1例为T1N0M0(I期)。4例患者术后均进行干扰素及IL-2治疗,2例有远处转移者同时行放疗。1例患者术后2个月因肝、肺、肋骨多发转移而死亡,余3例目前仍在随访中。结论:CDC临床症状明显,进展快,恶性程度高,预后差。主要治疗方法为肾癌根治术,患者多于术后数月或几年内发生转移而死亡。
Objective： To improve the diagnosis and treatment of renal collecting duct carcinoma （CDC） ; Methods： A retrospective study was done in 4 cases of CDC. Results： Among 283 cases of renal cell carcinoma admitted in our institute between April 2006 and July 30, 2007, 4 cases （1.41%） of CDC were identified. Three presented with abdominal and lumbar pain and 3 with hematuria,one caught low-grade fever and two emaciated with debll. Radical nephreetomies were taken in 4 cases. The primary tumors were located predominantly in the renal medulla. Historical examinations showed prominent tubular or tubulopapillary structures, nests and cords of tumor cells in desmoplastie stroma were identified in some cases. According to TNM tumor grade, two were in T2 N2 M1 （G4）, 1 was in T3aN0M0 （G3） and lin T1N0M0 （G1）. One patients died of metastases within 2 months, 3 are in follow-up. Conclusion：CDC is a distinctive renal cell carcinoma with prominent clinical appearance and progressive clinical course with pool prognosis. Radical nephrectomy is the best treatment, but most die of metastases in transitory survive after operations.
出处
《临床泌尿外科杂志》
2008年第9期671-673,共3页
Journal of Clinical Urology
关键词
肾集合管癌
诊断
治疗
预后
Collecting duct carcinoma
Diagnosis
Treatment
Prognosis
