多中心肾癌临床特征分析
Analysis of clinical characteristics of renal cell carcinoma in multi-centers
目的 总结我国肾癌的临床特征及诊治现状.方法 登记国内23家医院泌尿外科2007年8月至2008年10月诊治的2030例新发肾癌患者资料,对其中临床资料较完整1975例患者的发病情况、临床诊治情况进行分析.采用x~2检验或Fisher确切概率进行统计学分析. 结果 1975例中男1329例,女634例,未标明性别12例,男:女约为2.1:1.0.患病年龄2~93岁,平均54.5岁.41~70岁为肾癌高发年龄(74.3%).有肾癌临床表现者711例(36.0%),无症状肾癌1238例(62.7%),未标明26例.左肾癌958例(48.5%),右肾癌995例(50.4%),双肾癌22例(1.1%).肿瘤直径0.5~30.0 cm,中位值4.8 cm,平均值5.4 cm.肿瘤位于肾上、中、下极者分别为659例(32.9%)、717例(35.8%)、625例(31.2%),其中同时多部位肿瘤26例.临床分期T_1、T_2、T_3、T_4分别为1260例(63.8%)、455例(23.0%)、202例(10.2%)、58例(2.9%).手术治疗1844例,其中根治性肾切除术1500例(81.3%),保留肾单位手术325例(17.6%);开放手术1493例(81.0%),腹腔镜下手术351例(19.0%).病理结果:透明细胞癌1522例(84.5%),乳头状肾细胞癌98例(5.4%).结论 例行体检是发现早期肾癌的重要手段,根治性肾切除和开放手术是我国目前治疗肾癌最常用的手术方式.
更多Objective To analyze the clinical characteristics of renal cell carcinoma (RCC) and unveil the current status of diagnosis and treatments. Methods The registry data from 23 medical centers cover different areas of China. A total of 2030 new cases of RCCs in the 23 centers from Au-gust 2007 to October 2008 were collected, in which 1975 cases had integrated data for analysis. The symptoms, diagnostic techniques, pathology features, and therapeutic selection were analyzed. Re-sults A total of 1975 new cases were reviewed, with 1329 males and 634 females. The male and fe-male ratio was about 2.1 : 1.0. Of all cases, 1238 patients (62.7%) were asymptomatic and detected by examination, while 711 patients (36.0%) were symptomatic. 1260 patients (63.8%) were clinical stage Ⅰ , most of them were asymptomatic. 1844 patients were treated surgically, 1500(81.3%) un-derwent radical nephrectomy, 325 (17. 6%) underwent partial nephrectomy. Among the operations, open operation was performed in 1493 cases(81.0%), laparoscopic procedure in 351 cases(19.0%). There were 1522(84.5%) clear cell carcinomas, 98 (5.44%) papilliform renal cell carcinomas. Con-clusions Routine health examination could be an important way to diagnose early stage RCC. Open radical nephrectomy is the most often used surgical technique among the centres of present study.
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