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目的:探讨肾盂肉瘤样癌的临床、病理特点及预后。方法:回顾性分析就诊于我院的1例肾盂肉瘤样癌患者的临床及病理资料,并对2000~2015年CNKI和PubMed的文献进行查询,筛选肾盂肉瘤样癌患者的临床和病理资料,结合本例表现,总结肾盂肉瘤样癌患者的临床、病理特点及其预后。结果:肾盂肉瘤样癌患者大多以血尿及腰痛就诊,诊断时肿瘤大多已侵犯肌层。手术大多选择肾盂癌根治术。查询的32例患者中有6例复发,中位复发时间为3个月;13例患者死亡,中位死亡时间为7个月。经单因素Cox回归分析,发现患者的性别、年龄、地理位置、肿瘤大小、肿瘤位置、病理分级、是否伴有其他病理类型、治疗时是否有转移、患者手术后的放化疗等与预后无关。结论:肾盂肉瘤样癌就诊时多已经侵犯肾实质,其临床病理分期、分级高,常伴有多种病理类型;术后放化疗效果差,易远处转移,且目前没有明确的治疗方法,患者预后非常差。早期诊断、早期手术治疗才是提高患者预后的关键。
Objective: To investigate the clinical, pathological features and prognosis of pith sarcomatoid carcinoma. Methods: The clinical and pathological data of one patient with pyelosarcoid carcinoma treated in our hospital were retrospectively analyzed. The clinical and pathological data of CNKI and PubMed from 2000 to 2015 were searched. The clinical and pathological data of patients with pituitary sarcomatoid carcinoma were screened. In this case, summarize the clinical, pathological features and prognosis of patients with pituitary sarcomatoid carcinoma. Results: Most patients with pyelosarcoid carcinoma of the hematuria and low back pain treatment, most of the tumor has been diagnosed on the invasion of muscle. Surgery mostly choose radical nephroureterectomy. Of the 32 patients surveyed, 6 recurred, with a median recurrence of 3 months; 13 patients died and the median time to death was 7 months. Univariate Cox regression analysis found no correlation between the patient’s gender, age, geographical location, tumor size, tumor location, pathological grade, other pathological types, metastasis in the treatment, and postoperative chemoradiation. Conclusions: Most pituitary adenoid cystic carcinoma have already infiltrated the renal parenchyma at the time of diagnosis. The clinicopathologic staging, high grade, often accompanied by many pathological types. The postoperative chemoradiotherapy is poor, easily metastable, and there is no clear treatment, The patient’s prognosis is very poor. Early diagnosis, early surgical treatment is to improve the prognosis of patients.