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目的:加深对多房囊性肾细胞癌(MCRCC)的认识,提高术前诊断准确率并选择合适的治疗方法。方法:对我院2012年1月~2014年12月间14例囊性肾占位患者的临床表现、影像学、病理学及手术方式等临床资料进行研究与分析。结果:本研究共14例,男12例,女2例,年龄31~75岁。7例术前术后均诊断囊性肾癌,5例行肾部分切除术,2例行根治性肾切除。2例术前诊断为复杂性肾囊肿,行去顶减压术后病理结果为肾囊性透明细胞癌,1例术前诊断为双肾下极肾癌,术后病理结果为左肾透明细胞癌伴局部囊性透明细胞癌,右肾透明细胞癌;1例术前诊断为左肾多发囊肿,术后病理证实为囊性腺瘤,1例术前诊断囊性肾癌,术后病理结果为肾囊肿;1例术前诊断为双侧多囊肾伴部分囊壁钙化,术后病理为双侧多囊肾伴左肾乳头状肾细胞癌;1例术前诊断双侧多囊肾伴右肾下极占位,术后病理结果为右肾下极占位为囊性肾乳头状肾细胞癌伴有囊性肾透明细胞癌;14例患者术后随访3~12个月均未发现肿瘤复发。结论:MCRCC术前影像学容易误诊,最好的选择是保留肾单位手术,以尽量多保留肾功能以改善整体预后。
Objective: To deepen the understanding of multiple atrophic renal cell carcinoma (MCRCC), to improve the accuracy of preoperative diagnosis and select the appropriate treatment. Methods: Clinical data of 14 cases of cystic renal space occupying patients from January 2012 to December 2014 in our hospital were analyzed. Clinical data, such as imaging, pathology and surgical methods were studied and analyzed. Results: A total of 14 cases of this study, 12 males and 2 females, aged 31 to 75 years. Seven cases of cystic renal cell carcinoma were diagnosed before and after surgery, partial nephrectomy in 5 cases and radical nephrectomy in 2 cases. Two cases were diagnosed as complicated renal cysts preoperatively, the pathological results were renal cystic clear cell carcinoma after surgery, one case was diagnosed as preoperative renal inferior renal cell renal cell carcinoma, the postoperative pathological results were left renal clear cell 1 with preoperative diagnosis of multiple cysts of the left kidney, pathologically confirmed as cystadenoma, 1 case of preoperative diagnosis of cystic renal cell carcinoma, the pathological results were 1 case of preoperative diagnosis of bilateral polycystic kidney disease with partial wall calcification, postoperative pathological bilateral polycystic kidney disease with left renal papillary renal cell carcinoma; 1 case of preoperative diagnosis of bilateral polycystic kidney disease with right The location of the subrenal pole and the postoperative pathological findings were cystic renal papillary renal cell carcinoma with cystic renal clear cell carcinoma in the lower right renal pelvis. No tumor was found in 14 patients 3 to 12 months after operation relapse. CONCLUSIONS: Preoperative MCRCC imaging is often misdiagnosed, and the best option is to retain nephron surgery so as to preserve as much renal function as possible to improve overall prognosis.