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目的通过探讨多房囊性肾癌诊疗过程来提高其诊疗水平。方法回顾性分析我院2004年1月—2013年12月经手术病理证实的多房囊性肾癌32例,术前行影像学检查,按照Bosniak分类,Ⅱ类5例、ⅡF类8例、Ⅲ类19例。术前诊断为多房囊性肾癌28例,其中9例行肾根治术,19例行肾部分切除术,误诊为多房肾囊肿的3例行肾囊肿去顶减压术,术中快速冰冻病理2例为多房囊性肾癌随即改行肾部分切除术,1例术中冰冻病理为良性而术后病理示多房囊性肾癌,后期行根治性肾切除术。结果本组病例术后病理结果均为多房囊性肾癌,TNM分期均为T1N0M0期。组织分级:G122例、G210例。随访8~64个月,平均21.4个月,无肿瘤转移复发病例。结论完善的影像学检查及丰富的临床经验是提高多房囊性肾癌诊断准确率的关键,对于可疑病例有必要术中行快速冷冻病理检查。多房囊性肾癌可按照肾部分切除术指征首选保留肾单位手术治疗,疗效满意。
Objective To explore the diagnosis and treatment of multilocular cystic kidney cancer by improving its diagnosis and treatment. Methods Thirty-two cases of multilocular renal cell carcinoma confirmed by surgery and pathology in our hospital from January 2004 to December 2013 were retrospectively studied. According to the classification of Bosniak, there were 5 cases of type Ⅱ, 8 cases of type ⅡF, 19 cases. Preoperative diagnosis of multilocular renal cell carcinoma in 28 cases, of which 9 cases of radical nephrectomy, 19 cases of partial nephrectomy misdiagnosed as multiple renal cysts in 3 cases of renal cyst decompression surgery, intraoperative fast Frozen pathology in 2 cases of multilocular renal cell carcinoma then diverted partial nephrectomy, 1 case of intraoperative frozen pathology is benign and postoperative pathology showed multiple crenulated renal cell carcinoma, the late radical nephrectomy. Results The pathological results of this group of patients were all polycystic renal cell carcinoma, TNM staging were T1N0M0 stage. Tissue grading: G122 cases, G210 cases. All cases were followed up for 8 to 64 months with an average of 21.4 months without recurrence of tumor metastasis. Conclusion The perfect imaging examination and rich clinical experience are the key points to improve the diagnostic accuracy of multilocular cystic renal cell carcinoma. It is necessary to perform rapid frozen pathological examination in suspected cases. Multiple atrophic renal cell carcinoma can be retained in accordance with the preferred partial nephrectomy nephron surgical treatment, with satisfactory results.