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《肾癌诊断治疗指南》解读
近年来健康查体的普及使无症状肾癌的发病率逐年升高,近十年国内文献报道无症状肾癌平均发现率大约在33%,血尿、腰疼、腹部肿块"肾癌三联征"临床出现率则不到15%.在初诊的肾癌患者中,大约有30%为转移性肾癌,可以表现为咯血、骨痛、病理性骨折等一些症状.另外由于肾细胞癌可以产生多种内分泌激素,引起一些其他的临床表现,称为肾癌的副瘤综合征.约有10%-40%的肾癌患者会出现副瘤综合征.
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肾癌鼻窦转移一例
患者男,71岁,因反复左鼻腔出血1月余就诊.体格检查:左鼻腔内可见从中鼻道及鼻外侧突出一暗红色肿物,拇指大小,光滑,触之易出血.
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肾嫌色细胞癌的螺旋CT表现
肾嫌色细胞癌(chromophobe cell renal carcinoma,CCRC)是一种少见的肾癌亚型,5年生存率在所有的肾癌亚型中高,因而备受临床、病理学家关注.目前,国内外已有不少有关CCRC的临床病理学文献,但多局限于临床和病理特点的描述[1-3],而有关CCRC的影像学表现,迄今为止笔者仅见国外2篇报道[4,5].为此,笔者搜集经手术病理证实的CCRC6例,并结合文献探讨其CT表现.
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肾癌的诊断与鉴别诊断
肾癌又称肾细胞癌、肾腺癌、肾上腺样瘤或Grawitz瘤,是肾脏常见的实质性肿瘤,占成人肾实质恶性肿瘤之85%~95%,在泌尿系恶性肿瘤中,肾癌发病率仅次于膀胱癌.欧美国家的发病率明显高于亚洲国家.肾癌的发病率呈逐年上升趋势,美国统计2001年的发病率比1950年上升126%,病死率上升36.5%.我国尚无完整的统计资料,但从各地区的报道来看,发病率亦呈逐步上升趋势.
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肾癌伴下腔静脉癌栓病人围手术期护理
肾癌伴肾静脉及下腔静脉癌栓的发生率约为4%~10%[1],癌栓甚至可达右心房.因手术风险大且预后差,多数病人放弃手术.随着外科手术技术的发展,在对病人实施肾癌根治术的同时彻底切除下腔静脉中的癌栓,5年生存率可达25%~57%[1].1999年1月-2005年11月我院共收治肾癌伴下腔静脉癌栓病人15例,现将围手术期护理要点报告如下.
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螺旋CT对肾癌的诊断和分期
肾癌是泌尿系常见的恶性肿瘤,占原发性肾恶性肿瘤的80%~90%[1].CT检查是肾癌诊断及分期的重要方法 之一,对肾癌的预后评估及制定治疗方案具有重要的意义[2].现对我院经手术病理证实且资料完整的18例肾癌患者进行回顾性分析.
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肾脏偶发癌的CT诊断和术前分期
肾脏偶发癌是指因健康体检或其他疾病检查发现的肾癌.近年来随着影像技术的迅速发展和临床上的广泛应用,以及人们健康意识的提高,使该病的发现率不断提高,充分认识并正确诊断肾脏偶发癌意义重大.现回顾分析1994-12~2003-08经我院CT诊断并经手术病理证实的30例肾脏偶发癌,总结如下.
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囊性肾癌的影像诊断(附14例分析)
肾癌85%以上为实性,影像诊断并不困难,但少见的囊性肾癌易误诊为良性病变.为了提高囊性肾癌的诊断水平,本研究对术前经CT、MRI、DSA检查并手术病理证实的14例囊性肾癌进行回顾性分析.
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The skeleton is a common site of cancer metastasis. Notably high incidences of bone lesions are found for breast, prostate, and renal carcinoma. Malignant bone tumors result in significant patient morbidity. Identification of these lesions is a critical step to accurately stratify patients, guide treatment course, monitor disease progression, and evaluate response to therapy. Diagnosis of cancer in the skeleton typically relies on indirect bone-targeted radiotracer uptake at sites of active bone remodeling. In this manuscript, we discuss established and emerging tools and techniques for detection of bone lesions, quantification of skeletal tumor burden, and current clinical challenges.
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Objective:To study the expression of aminopeptidase N (CD13) in renal carcinoma and the effect of CD13 expression vector transfection on biological behavior of cancer cells.Methods:Renal carcinoma tissue and normal kidney tissue were collected and APN (CD13) contents in tissue were detected; renal carcinoma cell lines kevt-3 were cultured, 0 μg/mL, 10 μg/mL, 20 μg/mL, 40 μg/mL and 80 μg/mL of CD13 expression vector were transfected, and then migration ability, ATP generation capacity, and mRNA contents of migration and angiogenesis genes in cells were detected.Results:mRNA contents of APN in renal carcinoma tissue were higher than those in normal kidney tissue; the higher the clinical stage and pathological grade were, the higher the mRNA contents of APN in renal carcinoma tissue were; mRNA levels of APN in renal carcinoma tissue with lymph node metastasis were higher than those without lymph node metastasis;CD13 expression vector transfection could dose-dependently increase kevt-3 cell migration rate, ATP generation amount as well as mRNA contents of VEGF, HIF-1α, MMP9 and MMP10.Conclusion: Expression of aminopeptidase N (CD13) in renal carcinoma tissue abnormally increases; overexpression of CD13 can promote renal carcinoma cell migration and increase ATP generation as well as VEGF, HIF-1, MMP9 and MMP10 expression.