文档介绍：北京大学
硕士学位论文
肾癌267例临床分析
姓名:赵连明
申请学位级别:硕士
专业:泌尿外科
指导教师:马潞林
20050501
北京大学硕士学位论文

肾癌 267 例临床分析
A study of 267 cases of renal cell carcinoma

摘要
目的总结肾细胞癌的临床特点,探讨其诊断治疗方法及影响预后的危险因
素。
方法对我院 1985 年~2005 年 20 年间 267 例肾细胞癌患者的危险因素、诊
治和预后情况进行回顾性分析。通过 Cox 比例风险模型对预后因素进行评价。
结果 267 例随访病人中男女比例为 2:1,年龄平均 ± 岁,病程平
均 ± 个月,通过体检发现的病例共 144 例,占 %,典型肾癌“三联
征”的发生率仅为 %。主要的辅助检查是 B 超和 CT 检查。行根治性肾切除
术 217 例( % ),其他类型手术 49 例,其中肿瘤无法切除 3 例。病理结果:
透明细胞癌 218 例( % ),颗粒细胞癌 16 例( % ),乳头状腺癌 4 例
( % ),肉瘤样肾癌 6 例( % ),混合型癌 23 例( % )。随访 201 例,3 、
5 、10 年生存率分别为 %、 % 和 %。影响预后的主要危险因素是
术后转移、肿瘤分期及病理类型,保护因素是干扰素。
结论 B 超、CT 等检查手段的普及使无症状肾癌的发现日益增多,肾癌的
早期诊断是提高肾细胞癌生存率的关键;影响肾癌预后的主要危险因素是术后转
移、肿瘤分期及病理类型;干扰素免疫治疗对于改善肾癌预后有一定疗效。
关键词肾癌诊断治疗预后

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北京大学硕士学位论文

ABSTRACT

Objective To summarize the clinical characteristics of renal cell carcinoma
(RCC) and to explore the methods of diagnosis and treatment, and risk factors.
Methods 267 cases of renal cell carcinoma between 1985 year and 2005 year in
our hospital were reviewed for their risk factor ,diagnosis ,treatment and prognosis.
Significant prognostic factors were evaluated by Cox′s multivariate proportional
hazard model.
Results Among the 267 patients, the ratio of male to female was 2:1. The mean
age was ± years old. The mean course of diseases was ± months.
There are 144 patients found by physical examination. The classically described triad
(gross hematuria , flank pain , and a palpable mass) occurred in only %. The
diagnostic means were mainly ultrasonography and CT scanning. Radical
nephrectomy was done for 217 ( % ) and other procedures for 49 , among these ,
there are three tumors can’t be removed. The pathological results showed that 218
cases ( % ) were clear cell carcinoma , 16 cases ( % ) of granular cell
carcinoma , 23 cases ( % ) bination of the above two varieti