Doornweerd B H J, de Jong I J, Bergman L M, Ananias H J K
Department of Urology, University Medical Center Groningen, Groningen, The Netherlands,
World J Urol. 2014 Aug;32(4):1015-9. doi: 10.1007/s00345-013-1176-2. Epub 2013 Oct 6.
To evaluate the value of chest X-ray in the follow-up of surgically treated T1-3N0M0 renal cell carcinoma.
We performed retrospective analysis of patients that underwent surgical treatment of a localized renal cell carcinoma (T1-3N0M0) between January 1993 and July 2010. Data on frequency and results of performed chest X-rays were collected from patients' records.
In 17.5 years, 249 patients with a T1-3N0M0 renal cell carcinoma underwent a radical or partial nephrectomy. In 221 patients, 823 chest X-rays were performed during a median follow-up of 3.3 years (range 0.5-17 years). In 19 patients, a pulmonary recurrence occurred, of which 10 were not detected by the regular follow-up. Of the 9 patients that were diagnosed with a pulmonary recurrence with a chest X-ray during follow-up, 7 were asymptomatic at the time of diagnosis, and the chest X-ray has led to the detection; 0.85 % of the performed chest X-rays (7/823) have led to the detection of asymptomatic lung metastases.
Due to the low yield of chest X-ray for detection of asymptomatic pulmonary recurrences, it has very low clinical value in the follow-up after nephrectomy for T1-3N0M0 renal cell carcinoma.
评估胸部X线检查在T1-3N0M0期肾细胞癌手术治疗后随访中的价值。
我们对1993年1月至2010年7月间接受局限性肾细胞癌（T1-3N0M0）手术治疗的患者进行了回顾性分析。从患者病历中收集胸部X线检查的频率及结果数据。
在17.5年中，249例T1-3N0M0期肾细胞癌患者接受了根治性或部分肾切除术。221例患者在中位随访期3.3年（范围0.5 - 17年）内进行了823次胸部X线检查。19例出现肺部复发，其中10例在常规随访中未被发现。在随访期间通过胸部X线检查诊断为肺部复发的9例患者中，7例在诊断时无症状，胸部X线检查促成了检测；所进行的胸部X线检查中有0.85%（7/823）促成了无症状肺转移的检测。
由于胸部X线检查对无症状肺部复发的检出率低，其在T1-3N0M0期肾细胞癌肾切除术后的随访中临床价值极低。
