Jayson M, Sanders H
Division of Urology, Yale University School of Medicine, New Haven, Connecticut, USA.
Urology. 1998 Feb;51(2):203-5. doi: 10.1016/s0090-4295(97)00506-2.
To determine the proportion of renal cell carcinomas that are discovered serendipitously, and to compare the tumor stages of symptomatic versus incidental tumors.
We reviewed the charts of 131 consecutive patients who had a nephrectomy for renal cell carcinoma between 1989 and 1993. We excluded from the numerator any patients with abdominal pain or mass related to the tumor, even if the diagnosis of renal cell carcinoma had not been entertained before imaging studies.
Eighty (61%) of 131 patients were diagnosed with renal cell tumors in the absence of flank pain, flank mass, or hematuria. Of these 131 patients, 31 (24%) presented with gross hematuria, 13 (10%) with flank pain, and 10 (8%) with flank or abdominal mass. Only 1 patient presented with the classic triad of flank pain, flank mass, and gross hematuria. Eighty-five percent of asymptomatic tumors were Stage I or II, and 77% of symptomatic tumors were Stage I or II.
The great majority of renal cell tumors are found incidentally. The tumor stage is the same in the incidentally discovered cases as it is in the symptomatic cases.
确定偶然发现的肾细胞癌的比例，并比较有症状肿瘤与偶然发现肿瘤的肿瘤分期。
我们回顾了1989年至1993年间连续131例行肾细胞癌肾切除术患者的病历。我们从分子中排除了任何与肿瘤相关的腹痛或肿块患者，即使在影像学检查之前未考虑肾细胞癌的诊断。
131例患者中有80例（61%）在无胁腹痛、胁腹肿块或血尿的情况下被诊断为肾细胞肿瘤。在这131例患者中，31例（24%）出现肉眼血尿，13例（10%）出现胁腹痛，10例（8%）出现胁腹或腹部肿块。只有1例患者出现胁腹痛、胁腹肿块和肉眼血尿的典型三联征。85%的无症状肿瘤为I期或II期，77%的有症状肿瘤为I期或II期。
绝大多数肾细胞肿瘤是偶然发现的。偶然发现的病例与有症状的病例的肿瘤分期相同。
