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1、肾母细胞瘤40例临床病理分析作者：封琳，靳丹，潘毅，张连郁作者单位：焦作市第二人民医院病理科，河南焦作；天津医科大学附属肿瘤医院病理科，天津【摘要】目的探讨肾母细胞瘤的临床病理学特征及其对患者预后的影响。方法对40例肾母细胞瘤患者的临床及病理资料进行回顾性分析。结果肿瘤细胞呈小管状、乳头状、肾小球状及基底细胞状排列，并可见幼稚的黏液样细胞和纤维母细胞样梭形细胞，还可见平滑肌、横纹肌、骨、软骨及脂肪组织。40例中混合细胞性15例,富于间质性10例，囊性部分分化性4例，高分化上皮性1例，有间变成分6例，肉瘤性成分4例。临床分期：I期15例，II期20例，III期4例，IV期1例。40例中29
2、例获得随访，10例失访，1例拒访。29例中生存期超过10a者5例（囊性部分分化性4例，高分化上皮性1例），超过5a者10例（混合细胞性6例，富于间质性4例），14例复发者中5例（间变成分3例，肉瘤性成分2例）有血行转移而死亡，生存期8-37.5个刀，另9例复发后手术切除仍健在。结论肿瘤组织分化程度、肿瘤复发、血行或淋巴结转移是影响肾母细胞瘤预后的主要因素。【关键词】肾母细胞瘤，肿瘤，病理特征，预后Clinicalpathologicalanalysisof40casesofnephroblastomaFENGLin,JINDan,PANYi,etal1.DepartmentofPatho
3、logy,theSecondPeople1sHospitalofJiaozuoCityjiaozuo454001;2.DepartmentofPathology,theAffiliatedCancerHospitalofTianjinMedicalUniversity,Tianjin300060,ChinaAbstract:ObjectiveToprobetheclinicalpathologicalfeaturesofnephroblastoma,whichisalsocalledWilm'sTumor(WT).MethodsClinicalandpathologicaldataof4
4、0patientswithnephroblstomawereanalyzedretrospectively.ResultsHistologically,tumorcellsarrangedintoformsoftubular,papillary,glomerulus-likeorbasalcellstructures,surroundedbyimmaturemucoidcellsandfibroblast-likespindlecells.Smoothmuscles,striatedmuscles,bones,cartilageandadiposetissuescouldbeseen.O
5、fthe40cases,thereweremixed-cellularitynephroblastoma(15cases),nephroblastomarichinstroma(10cases),cysticpartiallydifferentiatednephroblastoma(4cases),well-differentiatedepithelialnephroblastoma(1case),anaplasticnephroblastoma(6cases),andsarcomatousnephroblastoma(4cases).Thedistributionofthe40pati
6、entsaccordingtothesurgicalstagewas:stageI15,stageII20,stagellI4andstageIV1・Twentycasesoutofthe40caseswerefollowedup,10withoutfollow-upvisit,andonerefusedfollow-upvisit.Ofthe29cases,fivecaseshadalifespanover10years(4casesofcysticpartiallydifferentiatednephroblastoma,onecaseofwell-differentiatedepi
7、thelialnephroblastoma),10caseswithalifespanover5years(6casesofmixed-cellularitynephroblastoma,4casesofnephroblastomarichinstroma);ofthe14recidivist,5caseswithalifespanof8monthsto37.5months(3casesofanaplasticnephroblast
