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[1]景抗震,傅点,徐晓峰,等.CT引导下经皮射频消融治疗T1bNxM0期孤立肾肿瘤的中长期随访观察[J].医学研究与战创伤救治(原医学研究生学报),2018,20(06):571-574.[doi:10.3969/j.issn.1672-271X.2018.06.003]
　JING Kang-zhen,FU Dian,XU Xiao-feng,et al.Mid-long term follow-up results of CT guided percutaneous radiofrequency ablation for renal cell tumor of T1b stage in solitary kidney[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2018,20(06):571-574.[doi:10.3969/j.issn.1672-271X.2018.06.003]
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CT引导下经皮射频消融治疗T1bNxM0期孤立肾肿瘤的中长期随访观察()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第20卷
期数:
2018年06期
页码:
571-574
栏目:
临床研究
出版日期:
2018-11-20

文章信息/Info

Title:
Mid-long term follow-up results of CT guided percutaneous radiofrequency ablation for renal cell tumor of T1b stage in solitary kidney
作者:
景抗震; 傅点; 徐晓峰; 葛京平; 周文泉; 张征宇; 郭宏骞; 程文
作者单位：210008南京，南京大学医学院附属鼓楼医院泌尿外科（景抗震、郭宏骞）；210002南京，南京大学医学院附属金陵医院(南京军区南京总医院)泌尿外科（傅点、徐晓峰、葛京平、周文泉、张征宇、程文）
Author(s):
JING Kang-zhen1; FU Dian2; XU Xiao-feng2; GE Jing-ping2; ZHOU Wen-quan2; ZHANG Zheng-yu2;  GUO Hong-qian1; CHENG Wen2
（1.Department of Urology，Gulou Hospital of Nanjing University School of Medicine, Nanjing 210008, Jiangsu, China；2.Department of Urology, Jinling Hospital, Nanjing University School of Medicine/Nanjing General Hospital of Nanjing Military Region, PLA, Nanjing 210002, Jiangsu, China）
关键词:
射频消融; 肾肿瘤; CT引导; 孤立肾
Keywords:
radiofrequency ablation; renal cell tumor; CT guided; solitary kidney
分类号:
R699.2
DOI:
10.3969/j.issn.1672-271X.2018.06.003
文献标志码:
A
摘要:
目的 评价CT引导下经皮射频消融治疗T1b期孤立肾肿瘤的中长期效果。方法 回顾性分析2007年4月至2010年1月在南京总医院就诊的生理性或功能性孤立肾肾肿瘤17例患者的临床资料，肿瘤均为单发，临床分期均为T1bNxM0期，术前经超声、CT及MRI等影像学检查明确诊断肾脏占位，行CT引导下经皮射频消融治疗。术后定期随访患者，复查CT观察复发情况，复查血肌酐计算肾小球滤过率（GFR）以判断肾功能，同时通过随访术后生存率及复发率评估治疗效果。结果 所有患者均顺利进行手术，平均手术时间（74±11）min，术中与术后未见严重并发症，无输血病例。术后1周复查CT提示14例肿瘤病灶完全消融，3例局部仍有增强信号，提示肿瘤残留；二次治疗后肿瘤消融完全。2例在术后6个月出现复发，1例在术后12个月出现复发，未再进行治疗，继续随访，其中1例在术后27个月时因肿瘤复发转移死亡。本组患者3年肿瘤相关生存率为94.12%，3年肿瘤复发率为17.65%。存活患者术后3年平均eGFR为（67.6±7.4）mL/（min·1.73m2），与术前比较差异无统计学意义（P＞0.05）。结论 CT引导下经皮射频消融治疗T1bNxM0期肾肿瘤安全有效，对肾脏功能影响小，有一定的肿瘤复发风险，但对于孤立肾患者，可以作为姑息性治疗的良好选择。
Abstract:
Objective To evaluate the effect of CT guided percutaneous radiofrequency ablation of T1b stage renal cell tumor with mid-long term follow-up.Methods All the 17 patients with a solitary kidney underwent surgery from April 2007 to January 2009. Renal tumor was diagnosed by ultrasonography, CT or MRI. All of the cases were T1bNxM0 stage. By CT positioning，percutaneous radiofrequency ablation were performed on the renal tumor. The patients were followed up regularly after operation. The recurrence rate was observed by CT, the glomerular filtration rate (GFR) was calculated by serum creatinine for judging the renal function. The therapeutic effect was evaluated by following up the survival rate and recurrence rate.Results All patients underwent percutaneous radiofrequency ablation surgery successfully. The mean operation time was （74±11）minutes. No blood transfusion occurred and no severe complication were observed during and post operation. During postoperative follow-up，enhanced CT revealed complete ablation in 14 cases, and 3 residue tumor was confirmed by enhanced CT 7 days post operation. After re-radiofrequency ablation, these 3 patients′ tumor were totally ruined. 3 cases of recurrence were confirmed by enhanced CT in 6-12 months after operation. 1 patient succumbed to tumor metastasis in 27th month after surgery. The 3-year recurrence rate was 17.65%. 3-year cancer specific survival rate was 94.12%. The mean eGFR was （67.6±7.4）mL/（min·1.73m2）in 3 years after surgery. There were no significant difference between pre- and post-operation (P>0.05).Conclusion Mid-long term follow-up Results show the effectiveness and safety of CT guided percutaneous radiofrequency ablation in the treatment for T1b stage renal cell tumor in patients with solitary kidney patients and have no negative influence on the renal function.

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备注/Memo

备注/Memo:
基金项目：国家自然科学基金（81572126）
更新日期/Last Update: 2018-11-20