摘要
目的:探讨肾脏集合管癌临床与病理学特点,提高对该病的诊治水平。方法:结合文献回顾性分析3例肾脏CDC患者的临床和病理资料并进行随访。3例均为男性,年龄55~83岁,平均70岁。其中左侧2例,右侧1例。2例有肉眼血尿,1例因尿频、尿急、夜尿次数增多就诊。结果:3例均行肾脏根治手术,肿瘤直径3~4 cm,平均直径3.5 cm。TNM分期1例Ⅲ期,2例Ⅰ期。病理学特点:肿瘤主要位于肾髓质内,组织学瘤细胞呈管状或管状乳头状结构,胞质嗜酸,核仁清晰;肿瘤细胞呈靴钉样,间质纤维增生,大量淋巴细胞浸润并有肿瘤旁集合管上皮细胞的异型增生。免疫组化显示肿瘤细胞34βE12、AE1/AE3、EMA、CK7和vimentin均呈阳性表达,CD10和CK20阴性表达。3例均获随访,随访时间3~26月,平均无瘤生存13月。结论:CDC具有独特的形态学特点,影像学检查缺乏特异性;肿瘤恶性程度高,进展快,预后较差。术后辅助放疗及免疫治疗作用有限。
Objective: To investigate the clinical and pathological features of renal collecting duct carcinoma(CDC), and to improve the diagnosis and treatment of the disease. Methods: A retrospective analysis was performedfor the clinical and pathological data of three patients with renal CDC, with reference to relevant literature, and thesepatients were followed up. All three patients were male, aged 55 ~ 83 years(mean 70 years). Of all patients, 2 hadCDC in the left kidney and 1 had CDC in the right kidney; 2 had gross hematuria, and 1 visited the hospital due tofrequency of urination, urgency of urination, and increased number of times of nocturia. Results: Radical nephrecto-my was performed for all 3 patients, and the tumor was 3 ~ 4 cm in diameter(mean 3.5 cm). According to TNM stag-ing, 1 had stage III disease and 2 had stage I disease. Major pathological features were as follows: most lesions werelocated in the renal medulla; the histological changes of tumor cells showed tubular or tubulo-papillary structure,with acidophilic cytoplasm and a clear nucleolus; there were hobnail-like tumor cells with interstitial fibroplasias,lymphocyte infiltration, and dysplasia of epithelial cells in the adjacent collecting duct. Immunohistochemistryshowed positive expression of 34βE12, AE1/AE3, EMA, CK7, and vimentin and negative expression of CD10 andCK20 in tumor cells. The patients were followed up for 3 ~ 26 months, and the mean disease-free survival was 13 months. Conclusions: CDC has unique morphological features, and imaging findings lack specificity. It has a highgrade of malignancy, rapid progression, and poor prognosis. Postoperative adjuvant radiotherapy and immune therapyhave limited clinical effects.
出处
《西南医科大学学报》
2018年第1期54-57,共4页
Journal of Southwest Medical University
关键词
肾肿瘤
集合管癌
病理学
预后
Kidney neoplasm
Collecting duct carcinoma
Pathology
Prognosis
