青年(18～40岁)非透明细胞型肾恶性肿瘤患者的临床病理特点及预后
Clinicopathological features and prognosis of non-clear cell renal cell carcinoma in young patients aged 18-40 years
唐世英 1薛子璇 1董靖晗 1邱敏 1田晓军 1陆敏 2张树栋 1马潞林1
作者信息
- 1. 北京大学第三医院泌尿外科,北京 100191
- 2. 北京大学第三医院病理科,北京 100191
- 折叠
摘要
目的 分析总结单中心青年(18～40 岁)非透明细胞型肾恶性肿瘤手术患者的临床、病理特征及预后,为同类患者的诊治提供参考.方法 回顾性分析 2012 年 1 月—2022 年 8 月于北京大学第三医院泌尿外科收治的 113 例青年非透明细胞型肾恶性肿瘤手术患者的病例资料,其中男性 57 例(50.4%),女性 56 例(49.6%);平均发病年龄(31.6±5.8)岁;左侧 57 例(50.4%)、右侧 56 例(49.6%).青年肾恶性肿瘤手术患者约占同期所有年龄段肾恶性肿瘤手术患者总数的 12.4%,其中青年非透明细胞型肾恶性肿瘤手术患者占同期青年肾恶性肿瘤手术患者总数的 34.8%.结果 102 例(90.3%)患者行微创手术(腹腔镜或机器人辅助),另外11 例(9.7%)行开放手术;肾部分切除术 55 例(48.7%),根治性肾切除术 58 例(51.3%),肾癌瘤栓患者 11 例(9.7%).手术均顺利完成,围手术期无严重并发症发生.病理类型包括肾嫌色细胞癌 32 例(28.3%)、MiT 家族易位性肾细胞癌 25 例(22.1%)、乳头状肾细胞癌 20 例(17.7%)、3 种病理亚型合计占总体的 68.1%.术后随访 46(2～115)个月,8 例(7.8%,8/102)出现肿瘤转移,2 例死亡.结论 青年非透明细胞型肾恶性肿瘤相对少见,病理类型以嫌色细胞癌为主,微创手术仍是该类肾恶性肿瘤患者的主要治疗方式,多数病理类型远期预后较好,合并瘤栓患者转移风险高、预后较差.
Abstract
Objective To summarize the clinicopathological features and prognosis of young patients(18-40 years old)with non-clear cell renal cell carcinoma(nccRCC)treated in a single center to provide reference for the diagnosis and treatment of similar patients.Methods Clinical data of 113 nccRCC patients treated during Jan.2012 and Aug.2022 were retrospectively analyzed,including 57 males(50.4%)and 56 females(49.6%).The average age of onset was(31.6±5.8)years.Among all patients,57 had lesions(50.4%)on the left side,and 56(49.6%)on the right side.Young patients undergoing renal cancer surgery accounted for approximately 12.4%of the total number of renal cancer patients undergoing surgery,and nccRCC accounted for 34.8%of the total number of cases.Results Minimally invasive surgery(laparoscopic or robot-assisted)was performed in 102 cases(90.3%),and open surgery in 11 cases(9.7%).Fifty-five cases(48.7%)underwent partial nephrectomy and 58(51.3%)radical nephrectomy.Among them,11 patients(9.7%)developed tumor thrombi.All surgeries were successful with no serious complications.The pathological types included 32 cases(28.3%)of chromophobe renal cell carcinoma,25 cases(22.1%)of MiT family translocation renal cell carcinoma,and 20 cases(17.7%)of papillary renal cell carcinoma.The total proportion of the three pathological subtypes reached 68.1%.After 46(2-115)months of follow-up,8 cases(7.8%,8/102)developed tumor metastasis and 2 died.Conclusion The nccRCC is rare in young patients.The major pathological type is chromophobe,and the major treatment method is minimally invasive surgery.Most pathological types have good long-term prognosis,while patients with tumor thrombi have a high risk of metastasis and poor prognosis.
关键词
青年/非透明细胞型肾恶性肿瘤/病理类型/肾嫌色细胞癌/微创手术Key words
youth/non-clear cell renal cell carcinoma/pathological types/chromophobe renal cell carcinoma/minimally invasive surgery引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据