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目的:探讨肾集合管癌的临床病理特征,提高对肾集合管癌的诊断和治疗水平。方法:回顾性分析5例肾集合管癌的临床资料:男4例,女1例,平均年龄54(42~65)岁。主要症状为腰腹痛、血尿及腹部包块和低热。4例患者行根治性肾癌切除术,1例行姑息性肾切除术。术后行病理学检查。结果:淋巴结转移3例,肾门脂肪转移2例;肿瘤位于肾髓质,侵袭性生长,以腺管或乳头状结构为主,特征性靴钉样细胞衬覆于管腔内面,伴有间质纤维反应,瘤旁集合管上皮细胞异型增生。AJCC临床分期Ⅱ期1例,Ⅲ期和Ⅳ期各2例。术后干扰素免疫治疗2例。随访5~18个月,5例患者平均生存10个月。结论:肾集合管癌具有特殊的临床病理特征,恶性程度高,预后差,其确诊依赖于病理学检查。早期发现、早期手术治疗仍是改善集合管癌预后的主要方法。
Objective: To investigate the clinical and pathological features of renal tubules and to improve the diagnosis and treatment of renal tubal cancer. Methods: A retrospective analysis of 5 cases of renal aggregate cancer clinical data: 4 males and 1 females, average age 54 (42 ~ 65) years old. The main symptoms are abdominal pain, hematuria and abdominal mass and fever. 4 patients underwent radical nephrectomy, 1 patient underwent palliative nephrectomy. Postoperative pathological examination. Results: There were 3 cases of lymph node metastasis and 2 cases of renal door fat metastasis. The tumor was located on the medulla of the kidney with aggressive growth. The main features of the duct were papillary or ductal papilla cells. Fibrous reaction, tumor-side tube epithelial dysplasia. AJCC clinical stage Ⅱ in 1 case, Ⅲ and Ⅳ in 2 cases. Postoperative interferon immunotherapy in 2 cases. Five to 18 months of follow-up, 5 patients survived an average of 10 months. CONCLUSIONS: Renal tubal carcinoma has special clinicopathological features with high malignancy and poor prognosis. Its diagnosis depends on pathological examination. Early detection, early surgical treatment is still to improve the prognosis of the main method of cancer.