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中华腔镜泌尿外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (04) : 381 -384. doi: 10.3877/cma.j.issn.1674-3253.2022.04.024

综述

早期肾细胞癌的影像引导消融治疗
张瑞敏1, 于杰2, 于晓玲2,()   
  1. 1. 10039 北京,中国人民解放军总医院介入超声科;014030 内蒙古包头市第四医院泌尿外科
    2. 10039 北京,中国人民解放军总医院介入超声科
  • 收稿日期:2021-01-22 出版日期:2022-08-01
  • 通信作者: 于晓玲

Image-guided ablation therapy for early renal cell carcinoma

Ruimin Zhang1, Jie Yu2, Xiaoling Yu2()   

  • Received:2021-01-22 Published:2022-08-01
  • Corresponding author: Xiaoling Yu
引用本文:

张瑞敏, 于杰, 于晓玲. 早期肾细胞癌的影像引导消融治疗[J]. 中华腔镜泌尿外科杂志(电子版), 2022, 16(04): 381-384.

Ruimin Zhang, Jie Yu, Xiaoling Yu. Image-guided ablation therapy for early renal cell carcinoma[J]. Chinese Journal of Endourology(Electronic Edition), 2022, 16(04): 381-384.

肾细胞癌(renal cell carcinoma,RCC)是泌尿生殖系统最常见的恶性肿瘤之一[1],随着影像成像技术的发展及人们健康意识的提高,小肾癌的检出率越来越高[2],超过80%的小肾癌(small renal cancer,SRMS)被证实为T1a期(最大径<4 cm)肾细胞癌[3],这种小病变的处理引起了很大的争议,潜在的选择是主动监视和保留肾单位的手术或者消融治疗[4,5]。治疗的指征是只有一个解剖或功能肾的孤立肾患者,或亲属有遗传性肾细胞癌,或患者合并可能进一步损坏肾功能疾病(如糖尿病等)的影响[6,7]。手术已经从根治术演变为肾部分切除术(partial nephrectomy,PN),后者包括开放性手术、常规的腹腔镜或机器人辅助下腹腔镜手术。目前,保留肾单位手术可使患者5年生存率达到90%,且最大程度保留肾功能,降低心血管事件的发生率[8,9,10,11]。对于不适合手术的患者,通常进行主动监测(active surveillance,AS),实行AS的患者通常要求肿瘤的生长速度相对较慢(2~3 mm/年),而且转移潜力低。然而,鉴于目前尚无可预测此类肿物的自然生长的生物标记物,因此需要用横断面成像进行密切监测,以检测那些将迅速增长的肿瘤[12,13,14],此外,瑞典肾癌质量登记册强调,即使是在1~4 cm的肿瘤,转移潜力也比人们普遍认为的要大[15]

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