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目的提高对偶发性肾癌的认识,达到早期诊治并了解影响预后的因素。方法对83例已行根治性肾切除术的偶发性肾癌进行回顾性分析,并与同期住院的其他肾癌进行比较。结果偶发肾癌的发生率为30.7%,两组在性别、年龄上无统计学意义;B超检查是诊断偶发肾癌的最早手段,CT是最主要的手段;偶发性肾癌分期明显低于其他肾癌(P<0.01)、体积(平均肿瘤直径3.9cm)明显小于其他肾癌(P<0.01)、5年生存率(83.8%)明显高于其他肾癌;多变量分析显示TNM分期和肿瘤细胞的组织学分化是判断预后的指标。结论偶发肾癌的发现率并不低,B超和CT是发现偶发性肾癌的主要手段。TNM分期低、细胞高分化、早期发现和尽早根治性肾切除术是偶发性肾癌较好的预后因素。
Objective To improve the understanding of patients with incidental renal cell carcinoma, achieve early diagnosis and treatment, and understand the factors that affect the prognosis. Methods A retrospective analysis was performed on 83 cases of recurrent renal cell carcinoma undergoing radical nephrectomy and compared with other renal cancer hospitalized in the same period. Results The incidence of incidental renal cell carcinoma was 30.7%. There was no significant difference in gender and age between the two groups. B-ultrasound was the earliest method to diagnose incidental renal cell carcinoma and CT was the most important method. The staging of incidental renal cell carcinoma was significantly lower than Other renal cell carcinoma (P <0.01), volume (average tumor diameter 3.9cm) was significantly smaller than other renal cell carcinoma (P <0.01), and 5-year survival rate was 83.8% Tumor cell histological differentiation is an indicator of prognosis. Conclusions The incidence of incidental renal cell carcinoma is not low. B-mode ultrasonography and CT are the main methods to detect incidental renal cell carcinoma. TNM staging low, cell differentiation, early detection and early radical nephrectomy is a better prognostic factor for incidental renal cell carcinoma.