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目的 研究肾集合管癌的临床病理特征。方法 回顾性研究肾集合管癌的临床及病理资料并进行随访。结果 10例肾集合管癌占肾癌的 2 1%。主要症状为血尿、腰腹痛。 9例行肾癌根治术 ,1例行肿瘤剜除术。肿瘤主要位于肾髓质 ,呈灰白色或淡黄色 ,侵袭性生长 ;以腺管乳头状结构为主 ,部分混有肉瘤样癌、腺样囊性癌、条索及巢状癌。Fuhrman病理分级 :G2 ,1例 ;G3,4例 ;G4,5例。TNM综合病理分期 :Ⅰ期 4例 ,Ⅱ期 2例 ,Ⅲ期 1例 ,Ⅳ期 3例。 6例死于肾癌转移 ,其中 1例术后19个月死于心脏病 ;2例无瘤生存 ;1例失访。平均生存时间 13 3个月。结论 肾集合管癌临床症状明显 ,临床病理分期高 ,进展快。主要治疗方法为肾癌根治术 ,多数病例于术后数月发生转移或死亡。
Objective To study the clinicopathological features of renal tubules. Methods The clinical and pathological data of renal aggregate carcinoma were retrospectively reviewed and followed up. Results 10 cases of renal tubular cancer accounted for 21% of renal cell carcinoma. The main symptoms are hematuria, abdominal pain. 9 cases of radical nephrectomy, 1 case of tumor resection. Tumors mainly in the medulla, gray or yellowish, aggressive growth; to duct papillary structures, some mixed with sarcomatoid carcinoma, adenoid cystic carcinoma, cords and neoplasms. Fuhrman pathological grading: G2, 1 case; G3,4 cases; G4,5 cases. TNM comprehensive pathological staging: Ⅰ in 4 cases, Ⅱ in 2 cases, Ⅲ in 1 case, Ⅳ in 3 cases. Six patients died of renal cell carcinoma metastasis, of which 1 died of heart disease 19 months after surgery; 2 patients survived without disease; and 1 patient was lost. The average survival time of 13 3 months. Conclusion The clinical symptoms of renal tubal carcinoma are obvious, with high clinical stage and advanced stage. The main treatment for radical nephrectomy, the majority of cases occurred in a few months after the transfer or death.