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成人肾脏原始神经外胚层肿瘤:12 例病例的治疗经验及文献系统回顾和荟萃分析。

Primary primitive neuroectodermal tumour of the kidney in adults: Experience of managing 12 cases with systematic review and pooled analysis of literature.

机构信息

Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Int J Clin Pract. 2021 Dec;75(12):e14971. doi: 10.1111/ijcp.14971. Epub 2021 Oct 20.

Abstract

INTRODUCTION

Primitive neuroectodermal tumor (PNET) of the kidney is unusual in adults. These tumours are diagnosed mainly on histopathology and that too sometimes has limitations. With this study, we aimed to review our clinical and histopathological data of patients with renal PNET and reviewing the world literature.

METHODS

In this retrospective study, we reviewed our database from January 2006 to July 2018 to include all the cases of primary PNET of the kidney. We also performed systematic literature search to identify all the relevant series on renal PNET.

RESULTS

A total of 12 patients including 5 men and 7 women were managed during the above mentioned period. Out of these 7 patients, 2 patients had metastasis at diagnosis, one had locally advanced disease, 6 underwent radical nephrectomy, 5 patients received adjuvant chemotherapy (two currently receiving) and only 1 patient received adjuvant radiotherapy (RT). On Immunohistochemistry (IHC), CD99 and FLI1 were positive in all the patients. Median survival was 10 months. In our review 10 studies were included, 38.6% of the patients had metastatic disease and 10.7% had locally advanced disease at diagnosis. Overall mean survival was 33.75 months. CD99 and FLI1 were positive in 94.3% and 78.5%, respectively.

CONCLUSION

PNET remains a pathological diagnosis and IHC has important place in diagnosis of PNET. Locally advanced and metastatic disease is common at diagnosis leading to overall poor survival.

摘要

介绍

成人肾脏原始神经外胚层肿瘤(PNET)较为罕见。这些肿瘤主要通过组织病理学诊断,但有时也存在一定的局限性。本研究旨在回顾我们的肾脏 PNET 患者的临床和组织病理学数据,并对世界文献进行复习。

方法

在这项回顾性研究中,我们回顾了 2006 年 1 月至 2018 年 7 月的数据库,纳入所有原发性肾脏 PNET 病例。我们还进行了系统的文献检索,以确定所有关于肾脏 PNET 的相关系列。

结果

在上述时间段内共管理了 12 例患者,包括 5 名男性和 7 名女性。其中 7 例患者在诊断时即发生转移,1 例患者局部晚期,6 例行根治性肾切除术,5 例患者接受辅助化疗(目前正在接受 2 例),仅 1 例患者接受辅助放疗。免疫组织化学(IHC)显示,所有患者的 CD99 和 FLI1 均为阳性。中位生存期为 10 个月。在我们的综述中纳入了 10 项研究,38.6%的患者在诊断时发生转移,10.7%的患者存在局部晚期疾病。总体平均生存率为 33.75 个月。CD99 和 FLI1 的阳性率分别为 94.3%和 78.5%。

结论

PNET 仍然是一种病理诊断,IHC 在 PNET 的诊断中具有重要地位。诊断时常见局部晚期和转移性疾病,导致总体生存不良。

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