Department of Urology, Peking Union Medical College Hospital, Beijing, China.
Department of Endocrinology, Peking Union Medical College Hospital, Beijing, China.
Front Endocrinol (Lausanne). 2021 Apr 30;12:646649. doi: 10.3389/fendo.2021.646649. eCollection 2021.
Juxtaglomerular cell tumor (JGCT) is a very rare disease, and surgical resection is the only possible way to cure this tumor. Open nephrectomy and partial nephrectomy have been reported to manage JGCTs with excellent results in the previous reviews. Laparoscopic surgery has been popularized in recent years, while critical issues associated with laparoscopic surgical management have been seldom reported. We summarized the JGCTs in our center to discover the optimal surgical management and its anatomic foundation.
In this retrospective study, we enrolled a total of 14 JGCT patients. All patients received surgeries and were followed up for up to 11 years. We mainly summarized the size and location of tumors, imaging features, and surgical strategies. A descriptive statistical analysis was performed.
The JGCTs in this study had a median size of 1.35 cm and all located superficially, mainly in the cortical or subcortical area of the kidney. All 14 patients had hypertension, ten had hypokalemia, and seven had elevated plasma renin activity. Pathologically, JGCT cells were polygonal or spindle shape, with positive CD34 and vimentin immunostaining. All patients received partial nephrectomy; nine were laparoscopic, and five were open. Laparoscopic partial nephrectomy (LPN) was performed in seven out of eight patients over the last nine years. Postoperative blood pressure, serum potassium, and plasma renin activity were normal in all patients. No recurrence occurred within a median follow-up of 60 months.
The small size and superficial location are the characteristic anatomic features of JGCT; they suggest that LPN is the preferred surgical strategy. Laparoscopic ultrasound is helpful for the intraoperative detection of small JGCTs. Longer follow-up is required to examine the biological behavior of JGCTs and the effect of LPN.
肾小球旁细胞瘤（JGCT）是一种非常罕见的疾病，手术切除是治愈这种肿瘤的唯一方法。之前的综述报道，开放性肾切除术和部分肾切除术在治疗 JGCT 方面取得了极好的效果。近年来，腹腔镜手术得到了普及，然而，腹腔镜手术管理相关的关键问题却很少有报道。我们总结了中心的 JGCT 病例，以发现最佳的手术管理及其解剖学基础。
在这项回顾性研究中，我们共纳入了 14 例 JGCT 患者。所有患者均接受手术治疗，并随访了长达 11 年。我们主要总结了肿瘤的大小和位置、影像学特征以及手术策略。采用描述性统计分析。
本研究中的 JGCT 肿瘤大小中位数为 1.35 厘米，均位于浅层，主要位于肾脏皮质或皮质下区域。14 例患者均有高血压，10 例有低钾血症，7 例有血浆肾素活性升高。病理上，JGCT 细胞呈多边形或梭形，CD34 和波形蛋白免疫染色阳性。所有患者均接受部分肾切除术；9 例为腹腔镜手术，5 例为开放性手术。在过去的 9 年中，有 8 例患者中的 7 例接受了腹腔镜部分肾切除术（LPN）。所有患者术后血压、血清钾和血浆肾素活性均恢复正常。中位随访 60 个月内无复发。
肿瘤体积小、位置表浅是 JGCT 的特征性解剖学特征；提示 LPN 是首选的手术策略。腹腔镜超声有助于术中检测小的 JGCT。需要更长时间的随访来检查 JGCT 的生物学行为和 LPN 的效果。
