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目的:探讨囊性肾癌(CRCC)的临床特点,提高其诊治水平。方法:回顾性分析27例CRCC患者的症状与体征、影像学表现、手术方式、病理检查及随访结果。结果:综合B超、CT、MRI、超声造影等检查诊断CRCC 24例,疑似肾癌2例,误诊为肾囊肿1例。行保留肾单位手术15例,根治性肾切除11例,肾囊肿去顶减压后再行根治性肾切除1例。病理检查报告为透明细胞癌26例,乳头状肾细胞癌1例;临床分期T1aN0M08例,T1bN0M012例,T2aN0M05例,T2bN0M02例;组织分级G16例,G221例。27例随访6~78个月,平均21个月,除1例术后3个月局部复发外,其余26例均无复发和转移。结论:综合多种影像学检查能提高CRCC的诊断率,部分患者保留肾单位手术能达到与根治性肾切除术同样的治疗效果。除肾癌囊性坏死型外,其余类型预后较好。
Objective: To investigate the clinical features of cystic renal cell carcinoma (CRCC) and improve its diagnosis and treatment. Methods: The clinical data of 27 patients with CRCC were retrospectively analyzed. The symptoms, signs, imaging findings, operation methods, pathological findings and follow-up results were analyzed. Results: Twenty-four cases of CRCC, two cases of suspected renal cell carcinoma and one case of renal cyst were diagnosed by B-ultrasound, CT, MRI and contrast-enhanced ultrasound. Line retained 15 cases of nephrons surgery, radical nephrectomy in 11 cases, renal cysts after decompression and then radical nephrectomy in 1 case. Pathological examination was reported in 26 cases of clear cell carcinoma and 1 case of papillary renal cell carcinoma. Clinical stage T1aN0M08 cases, T1bN0M012 cases, T2aN0M05 cases, T2bN0M02 cases, and tissue grading G16 cases and G221 cases. Twenty-seven patients were followed up for 6 to 78 months with an average of 21 months. Except for 1 case of local recurrence 3 months after operation, the remaining 26 cases showed no recurrence and metastasis. Conclusion: The comprehensive multiple imaging examination can improve the diagnostic rate of CRCC, some patients retain nephron surgery can achieve the same effect as radical nephrectomy. In addition to renal cystic necrosis type, the other types of better prognosis.