Nakano E, Iwasaki A, Seguchi T, Kokado Y, Yoshioka T, Sugao H, Koide T
Department of Urology, Osaka University Medical School, Japan.
Eur Urol. 1992;21(4):294-8. doi: 10.1159/000474860.
We analyzed the incidence, sex and age distribution, diagnostic methods and survival rate of incidentally detected renal cell carcinomas (RCCs) and compared these factors with those of symptomatic RCCs. Of 141 patients with RCC treated between 1980 and 1989, 44 cases (31.4%) were incidentally detected. Thirty-one of these 44 cases were diagnosed by abdominal ultrasonography. The age of the incidental cases was significantly higher than that of the symptomatic ones (p = 0.045), particularly in male patients (p = 0.049). The tumor size in incidental cases was smaller and tumor stage earlier (p less than 0.0001). Moreover, the grade of malignancy was significantly lower, and clear cell type tumors were more frequently detected in the incidental cases. No difference was observed between the survival rates of incidental and symptomatic cases with stage 1 or 2 tumors. Of the incidental cases with stage 1 or 2, however, no patient with a tumor 3 cm or less in diameter has died. In conclusion, abdominal ultrasonography is a useful tool to detect RCC at an early stage, and patients with a relatively small tumor tend to have a good prognosis.
我们分析了偶然发现的肾细胞癌（RCC）的发病率、性别和年龄分布、诊断方法及生存率，并将这些因素与有症状的RCC患者的相关因素进行比较。在1980年至1989年期间接受治疗的141例RCC患者中，44例（31.4%）是偶然发现的。这44例中有31例通过腹部超声检查确诊。偶然发现病例的年龄显著高于有症状病例（p = 0.045），在男性患者中尤其明显（p = 0.049）。偶然发现病例的肿瘤大小较小，肿瘤分期较早（p < 0.0001）。此外，偶然发现病例的恶性程度显著较低，且透明细胞型肿瘤更常见。1期或2期肿瘤的偶然发现病例和有症状病例的生存率之间未观察到差异。然而，在1期或2期的偶然发现病例中，直径3 cm或更小的肿瘤患者无一死亡。总之，腹部超声检查是早期发现RCC的有用工具，肿瘤相对较小的患者往往预后良好。
