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目的:分析乳头状肾细胞癌(PRCC)及集合管癌的临床、病理特点,并阐明其诊断、鉴别诊断及预后判断要点.方法:结合随访资料,对25例PRCC、10例集合管癌(CDC)的临床、病理学、组织化学及免疫组织化学特征进行分析.结果:25例PRCC和10例CDC分别占同期肾癌的10.12%和4.05%,血尿为最常见的首发症状,PRCC表现为囊性肾癌的影像学特征,CDC位于肾髓质部占位性病变.两者均在组织学上表现为乳头状结构,PRCC中可见淋巴细胞,泡沫细胞及砂粒体,CDC呈高柱状细胞,PAS染色阳性,PNA强阳性.5年生存率显示PRCC(47%)和非乳头状肾癌(58%)无显著性差异,CDC的5年生存率(20%)显著低于前两者(P<0.05).结果还显示,PNA及PCNA高表达者预后差.结论:乳头状肾癌及集合管癌是肾癌的少见类型,有特异的临床、病理特征,PNA及PCNA染色可帮助判断肾癌预后.
OBJECTIVE: To analyze the clinical and pathological features of papillary renal cell carcinoma (PRCC) and ductal carcinoma and to clarify the diagnostic, differential diagnosis and prognostic points.Methods: According to the follow-up data, 25 cases of PRCC, 10 cases of ductal carcinoma CDC) were analyzed.Results: 25 cases of PRCC and 10 cases of CDC accounted for 10.12% and 4.05% of the same period of renal cell carcinoma, hematuria was the most common first symptom, PRCC showed Cystic renal cell carcinoma imaging features, CDC in the medullary mass lesions, both histologically manifested as papillary structures, lymphocytes, foam cells and sand bodies can be seen in PRCC, CDC were high columnar cells , PAS positive and PNA strongly positive.The 5-year survival rate showed no significant difference between PRCC (47%) and non-papillary renal cell carcinoma (58%), and the 5-year survival rate (20%) of CDC was significantly lower than the former two (P <0.05) .The results also showed that PNA and PCNA high expression of poor prognosis.Conclusion: Papillary renal carcinoma and tuberculous carcinoma is a rare type of renal cell carcinoma, with specific clinical and pathological features, PNA and PCNA staining can help To determine the prognosis of renal cell carcinoma.