【摘要】 目的探讨低度恶性潜能的多房囊性肾肿瘤（MCRNLMP）的临床病理特征及诊疗。方法选择福建省立医院泌尿外科2004～2018年期间收治的35例MCRNLMP患者,其中施行根治性肾肿瘤切除术（RN）4例,开放保留肾单位肾部分切除术（ONSS）19例,腹腔镜下（经腹或经腰）肾部分切除术（LNSS）12例。回顾性分析其临床资料。结果 MCRNLMP总体发病率上,男性高于女性（1.92∶1）。患肾均为单侧单发,无偏极倾向。肿瘤平均直径为3.56 cm。术后共8例（22.8%）发生并发症,其中6例为轻微（17.1%）,2例严重（5.7%）,均转归良好。切缘残留阳性3例（其中ONSS组1例,LNSS组2例）。TNM分期中,31例（88.6%）为T₁N₀M₀,4例（11.4%）为T₂N₀M₀,未发现T₃及更高。Fuhrman核分级方面,Ⅰ级为23例（65.7%）,Ⅱ级12例（34.3%）,未发现Ⅲ或Ⅳ级。在平均随访期内（76.3月）,仅1例局部复发,余均未发现肿瘤复发或转移的征象,无瘤生存率（DFS）为97.1%。结论 MCRNLMP患者术后短、中期预后极佳,在完整切除肿瘤的前提下其预后趋势与瘤体大小、切缘阳性等因素无明显相关。推荐LNSS作为处理此特殊类型肿瘤的首选术式。更多还原

【Abstract】 Objective To investigate the clinical pathology characteristics of multiocular cystic renal cell neoplasm of low malignant potential（MCRNLMP）and the options of diagnosis and treatment.Methods This study cohort included 35 MCRNLMP cases obtained through our single-institution from 2004 to 2018.In all,4 patients underwent radical nephrectomy,19 patients received open nephron-sparing surgery（ONSS）and 12 patients were treated with trans-abdominal or trans-radial laparoscopic nephron-sparing surgery（LNSS）.The patients’ clinical pathologic outcomes were retrospectively analyzed and reported.Results MCRNLMP occurred more often in men than in women（1.92∶1）.All patients had unilateral tumor with no side predominance.Average size of tumor was 3.56 cm.Of the total,8 patients（22.8%）had common complications after surgery.Minor complications and major complications occurred in 6 patients（17.1%）and 2 patients（5.7%）,respectively.All patients with proper treatments were associated with excellent outcome.It was found that the positive surgical margin remained in 3 patients（1 for ONSS and 2 for LNSS group）following surgery.According to the TNM stage system,31 patients（88.6%）belonged to stage T₁N₀M₀ and 4 patients（11.4%）belonged to stage T₂N₀M₀,none of the patients had stage T₃ or above.Acoording to the Fuhrman nuclear grading system 23 patients（65.7%）was classified into Grade Ⅰ,12 patients（34.3%）into Grade Ⅱ,none into Grade Ⅲ or Ⅳ.In our study,all patients were alive and only 1 patient presented with local recurrence and the rest of patients didn’t have clinical evidence of recurrence or metastatic disease by imaging techniques at mean follow-up time of 76.3 months,which showed that the overall disease-free survival rate（DFS）was 97.1%.Conclusion Comparison of results with those obtained in other reports in the literature,we certificate that MCRNLMP associates with excellent early and mid-term prognosis after successful surgery.Also we reveal that this special type of tumor can be cured by total excision,and the overall prognostic trends are not adversely affected by tumor size or the positive surgical margin status observed occasionally in our cases.Therefore we recommend that LNSS could gradually take the place of traditional ONSS as a standard treatment for MCRNLMP.更多还原