Rivas del Fresno M, Fernández Gómez J M, San Martín Blanco A, Sahagún Argüello J L, Martín Benito J L, Alonso Sainz F
Servicio de Urología, Hospital Covadonga, Oviedo, Asturias, España.
Arch Esp Urol. 1995 Jan-Feb;48(1):67-71.
We evaluated the form of presentation, clinical features and analytical values and their relationship with survival in renal cell carcinoma patients and analyzed the efficiency of different diagnostic and staging procedures.
We reviewed the form of presentation, clinical features, staging procedures and analytical values of 229 consecutive renal cell carcinomas diagnosed at our hospital between 1975 and 1991.
Malaise and weight loss or symptoms different from those of the classical triad (hematuria, pain and a flank mass) are factors of poor prognosis and lower survival. The time of presentation of symptoms does not influence prognosis. Computerized tomography was found to be the best imaging technique, with a low sensitivity and a high specificity in our experience. We have found a correlation between hypercalcemia and lower survival, but not for the more advanced tumoral stage. There was a correlation between the levels of hemoglobin and alkaline phosphatase and survival: patients with hemoglobin levels less than 14 g/dl or alkaline phosphatase levels greater than 85 U/l had a lower survival rate and a more advanced tumoral stage.
Computerized tomography was found to be the best imaging technique. Symptoms different from those of the classical triad, malaise and weight loss, hypercalcemia, low levels of hemoglobin or high levels of alkaline phosphatase are factors of poor prognosis.
我们评估了肾细胞癌患者的临床表现形式、临床特征和分析值及其与生存的关系，并分析了不同诊断和分期程序的效率。
我们回顾了1975年至1991年间在我院连续诊断的229例肾细胞癌的临床表现形式、临床特征、分期程序和分析值。
全身不适、体重减轻或与经典三联征（血尿、疼痛和侧腹肿块）不同的症状是预后不良和生存率较低的因素。症状出现的时间不影响预后。根据我们的经验，计算机断层扫描被认为是最佳的成像技术，其敏感性低但特异性高。我们发现高钙血症与较低的生存率相关，但与更晚期的肿瘤分期无关。血红蛋白水平和碱性磷酸酶水平与生存率之间存在相关性：血红蛋白水平低于14 g/dl或碱性磷酸酶水平高于85 U/l的患者生存率较低且肿瘤分期更晚。
计算机断层扫描被认为是最佳的成像技术。与经典三联征不同的症状、全身不适和体重减轻、高钙血症、低血红蛋白水平或高碱性磷酸酶水平是预后不良的因素。
