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1、腎母細(xì)胞瘤40例臨床病理分析作者：封琳，靳丹，潘毅，張連郁作者單位：焦作市第二人民醫(yī)院病理科，河南焦作；天津醫(yī)科大學(xué)附屬腫瘤醫(yī)院病理科，天津【摘要】目的探討腎母細(xì)胞瘤的臨床病理學(xué)特征及其對患者預(yù)后的影響。方法對40例腎母細(xì)胞瘤患者的臨床及病理資料進(jìn)行回顧性分析。結(jié)果腫瘤細(xì)胞呈小管狀、乳頭狀、腎小球狀及基底細(xì)胞狀排列，并可見幼稚的黏液樣細(xì)胞和纖維母細(xì)胞樣梭形細(xì)胞，還可見平滑肌、橫紋肌、骨、軟骨及脂肪組織。40例中混合細(xì)胞性15例,富于間質(zhì)性10例，囊性部分分化性4例，高分化上皮性1例，有間變成分6例，肉瘤性成分4例。臨床分期：I期15例，II期20例，III期4例，IV期1例。40例中29
2、例獲得隨訪，10例失訪，1例拒訪。29例中生存期超過10a者5例（囊性部分分化性4例，高分化上皮性1例），超過5a者10例（混合細(xì)胞性6例，富于間質(zhì)性4例），14例復(fù)發(fā)者中5例（間變成分3例，肉瘤性成分2例）有血行轉(zhuǎn)移而死亡，生存期8-37.5個(gè)刀，另9例復(fù)發(fā)后手術(shù)切除仍健在。結(jié)論腫瘤組織分化程度、腫瘤復(fù)發(fā)、血行或淋巴結(jié)轉(zhuǎn)移是影響腎母細(xì)胞瘤預(yù)后的主要因素。【關(guān)鍵詞】腎母細(xì)胞瘤，腫瘤，病理特征，預(yù)后Clinicalpathologicalanalysisof40casesofnephroblastomaFENGLin,JINDan,PANYi,etal1.DepartmentofPatho
3、logy,theSecondPeople1sHospitalofJiaozuoCityjiaozuo454001;2.DepartmentofPathology,theAffiliatedCancerHospitalofTianjinMedicalUniversity,Tianjin300060,ChinaAbstract:ObjectiveToprobetheclinicalpathologicalfeaturesofnephroblastoma,whichisalsocalledWilm'sTumor(WT).MethodsClinicalandpathologicaldataof4
4、0patientswithnephroblstomawereanalyzedretrospectively.ResultsHistologically,tumorcellsarrangedintoformsoftubular,papillary,glomerulus-likeorbasalcellstructures,surroundedbyimmaturemucoidcellsandfibroblast-likespindlecells.Smoothmuscles,striatedmuscles,bones,cartilageandadiposetissuescouldbeseen.O
5、fthe40cases,thereweremixed-cellularitynephroblastoma(15cases),nephroblastomarichinstroma(10cases),cysticpartiallydifferentiatednephroblastoma(4cases),well-differentiatedepithelialnephroblastoma(1case),anaplasticnephroblastoma(6cases),andsarcomatousnephroblastoma(4cases).Thedistributionofthe40pati
6、entsaccordingtothesurgicalstagewas:stageI15,stageII20,stagellI4andstageIV1?Twentycasesoutofthe40caseswerefollowedup,10withoutfollow-upvisit,andonerefusedfollow-upvisit.Ofthe29cases,fivecaseshadalifespanover10years(4casesofcysticpartiallydifferentiatednephroblastoma,onecaseofwell-differentiatedepi
7、thelialnephroblastoma),10caseswithalifespanover5years(6casesofmixed-cellularitynephroblastoma,4casesofnephroblastomarichinstroma);ofthe14recidivist,5caseswithalifespanof8monthsto37.5months(3casesofanaplasticnephroblast
