肾细胞癌副肿瘤综合征的临床特点及其预后

杨瑜; 毛全宗; 李汉忠; 纪志刚; 严维刚; 荣石; 刘广华; 徐维锋; 肖河; 王惠君

doi:10.3969/j.issn.1674-9081.2012.02.014

肾细胞癌副肿瘤综合征的临床特点及其预后

Clinical Features and Prognosis of Paraneoplastic Syndromes in Renal Malignancies

摘要

摘要:
目的探讨肾脏恶性肿瘤伴发副肿瘤综合征的临床特点及其与预后的关系。
方法回顾性分析北京协和医院2008年1月至2009年12月464例经手术和病理确诊的肾细胞癌患者的临床资料及其随访结果。
结果 464例肾细胞癌患者中伴发副肿瘤综合征156例(33.6%), 主要临床表现为贫血(26.3%, 41/156)、高血压(24.4%, 38/156)、发热(21.8%, 34/156)、红细胞增多症(19.2%, 30/156)、Stauffer综合征(17.3%, 27/156)、食欲不振、乏力、体重减轻(15.4%, 24/156)、血沉加快(12.8%, 20/156)、白细胞增多症(8.3%, 13/156)、高钙血症(5.1%, 8/156)、糖代谢紊乱(1.9%, 3/156)、性激素异常(0.6%, 1/156)等。156例伴发副肿瘤综合征患者的肿瘤平均直径为5.5 cm, 其余患者肿瘤平均直径为4.7 cm, 两者比较差异有统计学意义(P < 0.01)。
结论肾脏恶性肿瘤副肿瘤综合征的发生率约为33.6%, 其出现与肿瘤分期有相关性。

Abstract:
Objective To investigate the clinical features and prognosis of paraneoplastic syndromes (PNS) in patients with renal carcinoma.
Methods The clinical data and follow-up results of 464 patients with surgically and pathologically confirmed renal cell carcinoma (RCC) were retrospectively reviewed.
Results Of these RCC cases, PNS was identified in 156 patients (33.6%) and manifested as anemia (26.3%, 41/156), hypertension (24.4%, 38/156), fever (21.8%, 34/156), polycythemia (19.2%, 30/156), Stauffer's syndrome (17.3%, 27/156), fatigue, weight loss, and anorexia (15.4%, 24/156), high erythrocyte sedimentation rate (12.8%, 20/156), leukocytosis (8.3%, 13/156), hypercalcemia (5.1%, 8/156). The average diameter of tumors was 5.5 cm in these 156 patients and was 4.7 cm in the remaining patients (P < 0.01).
Conclusion The incidence of RCC is about 33.6% in patients with renal carcinoma, and the morbidity may be associated with the tumor stages.

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