跳转到内容

腎癌：修订间差异

维基百科，自由的百科全书
以互动方式浏览历史
←上一版本下一版本→
删除的内容 添加的内容
可视化wikitext
Kaguya-Taketori（留言 | 贡献）
21,739次编辑
无编辑摘要
Kaguya-Taketori（留言 | 贡献）
21,739次编辑
小无编辑摘要
第14行： 第14行：
| MeshID = D007680
| MeshID = D007680
}}
}}
腎癌（{{link-en|Kidney cancer or renal cancer}}），係一種由腎臟細胞癌變引發的癌症。
腎癌（{{lang-en|Kidney cancer or renal cancer}}），係一種由腎臟細胞癌變引發的癌症。


兩種最普遍的腎癌分別是{{link-en|腎細胞癌|renal cell carcinoma}}（renal cell carcinoma, 縮寫爲RCC）和發於{{link-en|腎盂|Renal pelvis}}的{{link-en|移行細胞癌|transitional cell carcinoma}}（transitional cell carcinoma, 縮寫爲TCC）。這兩種癌症的名字顯示了相應癌變發生的部位。
兩種最普遍的腎癌分別是{{link-en|腎細胞癌|renal cell carcinoma}}（renal cell carcinoma, 縮寫爲RCC）和發於{{link-en|腎盂|Renal pelvis}}的{{link-en|移行細胞癌|transitional cell carcinoma}}（transitional cell carcinoma, 縮寫爲TCC）。這兩種癌症的名字顯示了相應癌變發生的部位。

2015年6月27日 (六) 05:58的版本

腎癌
顯微鏡下展示出的最常見的一種腎癌（右側的透明細胞是腎細胞癌（英语：renal cell carcinoma）），圖中組織是用蘇木精-伊紅染色法染色的
症状血尿、胃口不佳、减肥、疲倦、发热、流汗[*]、背痛
类型urinary system cancer[*]、肾肿瘤[*]、腎病變、疾病
治療腎切除術[*]
分类和外部资源
醫學專科腫瘤
ICD-112C90
MeSHD007680
[编辑此条目的维基数据]

腎癌（英語：Kidney cancer or renal cancer），係一種由腎臟細胞癌變引發的癌症。

兩種最普遍的腎癌分別是腎細胞癌（英语：renal cell carcinoma）（renal cell carcinoma, 縮寫爲RCC）和發於腎盂的移行細胞癌（英语：transitional cell carcinoma）（transitional cell carcinoma, 縮寫爲TCC）。這兩種癌症的名字顯示了相應癌變發生的部位。

種類不同的腎癌，其發病機理也不同，每種腎癌產生的長期效應也不相同。另外，治療腎癌需要對癌症進行癌症分期，並根據分期結果進行相應治療。80%的早期腎癌都是腎細胞癌，而發於腎盂的移行細胞癌又佔了其餘20%中的大部分 [1]。

美國腎癌患者的五年生存率爲73%[2]。

Types

Micrograph of a kidney cancer (chromophobe renal cell carcinoma, oncocytic variant), that may be challenging to differentiate from a benign kidney tumour (renal oncocytoma). H&E stain.
Micrograph of papillary renal cell carcinoma, a form of kidney cancer. H&E stain.

In addition to renal cell carcinoma and renal pelvis carcinoma, other, less common types of kidney cancer include:

Rarely, some other types of cancer and potentially cancerous tumors that more usually originate elsewhere can originate in the kidneys. These include:

Cancer in the kidney may also be secondary, the result of metastasis from a primary cancer elsewhere in the body.

Signs and symptoms

The most common signs and symptoms of kidney cancer are a mass in the abdomen and/or blood in the urine (or hematuria). Other symptoms may include tiredness, loss of appetite, weight loss, a high temperature and heavy sweating, and persistent pain in the abdomen.[7][8] However, many of these symptoms can be caused by other conditions, and there may also be no signs or symptoms in a person with kidney cancer, especially in the early stages of the disease.

Stages

  • Stage 1 kidney cancer
    Stage 1 kidney cancer
  • Stage 2 kidney cancer
    Stage 2 kidney cancer
  • Stage 3 kidney cancer
    Stage 3 kidney cancer
  • Stage 4 kidney cancer
    Stage 4 kidney cancer

Causes

Factors that increase the risk of kidney cancer include smoking, which can double the risk of the disease; regular use of NSAIDs such as ibuprofen and naproxen, which may increase the risk by 51%[9] or may not;[10] obesity; faulty genes; a family history of kidney cancer; having kidney disease that needsdialysis; being infected with hepatitis C; and previous treatment for testicular cancer or cervical cancer.

There are also other possible risk factors such as kidney stones [11] and high blood pressure, which are being investigated.[12]

Pathophysiology

Kidney cancer originates in the kidney in two principal locations: the renal tubule and the renal pelvis. Most cancers in the renal tubule are renal cell carcinoma and clear cell adenocarcinoma. Most cancers in the renal pelvis are transitional cell carcinoma.

Treatment

Treatment for kidney cancer depends on the type and stage of the disease. Surgery is typically the mainstay of treatment and it usually doesn't involve chemotherapy and radiotherapy, as kidney cancers often do not respond to these treatments.

Diagram showing laparoscopic kidney removal surgery

If the cancer has not spread, it will usually be removed by surgery. Sometimes this involves removing the whole kidney, which is callednephrectomy but most tumors are amenable to partial nephrectomy which is removing of the kidney tumor only and preserving the remaining normal kidney. Unfortunately, surgery is not always possible - for example the patient may have other medical conditions that prevent it, or the cancer may have spread around the body and doctors may not be able to remove it.[13] There is currently no evidence that body-wide medical therapy after surgery where there is no known residual disease, that is, adjuvant therapy, helps to improve survival in kidney cancer. If the cancer can't be cured with surgery, sometimes doctors may use other techniques such as cryotherapy (freezing the tumour away) orradiofrequency ablation (burning the tumour away). However these are not yet used as standard treatments for kidney cancer.[14] Other treatment options include biological therapies (drug treatments that use natural substances from the body) such as Everolimus (Afinitor), Temsirolimus (Torisel), Sorafenib (Nexavar),Sunitinib (Sutent), and Axitinib (Inlyta), the use of immunotherapy including interferon and interleukin-2.[15][16][17] Immunotherapy has the potential to induce complete remissions or durable partial remissions in some patients, although it works in only about 10 to 15% of patients.[18]

In Wilms' tumor (a type of kidney cancer that affects children), chemotherapy, radiotherapy and surgery are the accepted treatments, depending on the stage of the disease when it is diagnosed.[19] Other rare forms of kidney cancer are not discussed here.

IMA901 is used to treat patients with cancer of the kidneys. It is composed of ten synthetic tumor-associated peptides (TUMAPs), which activate the body's own killer T-cells against the tumor. Unlike chemotherapy, this process targets the body's immune responses and mobilizes them to attack the cancer.

Children

The majority of kidney cancers reported in children are Wilms' tumors. These tumors can begin to grow when a fetus is still developing in the uterus, and may not cause problems until the child is a few years old. Wilms' tumor is most common in children under the age of 5, but can rarely be diagnosed in older children or in adults. It is still not clear what causes most Wilms' tumors. The most common symptoms are swelling of the abdomen and blood in the child's urine.[19]

Epidemiology

Around 208,500 new cases of kidney cancer are diagnosed in the world each year, accounting for just under 2% of all cancers.[20] The highest rates are recorded in Northern America and the lowest rates in Asian and African regions.[21]

United States

The United States' NIH estimates for 2013 around 64,770 new cases of kidney cancer and 13,570 deaths from the disease.[22]

The incidence of kidney cancer is also increasing in the United States. This is thought to be a real increase, not only due to changes in the way the disease is diagnosed.[23]

Europe

The most recent estimates of incidence of kidney cancer suggest that there are 63,300 new cases annually in the EU25. In Europe, kidney cancer accounts for nearly 3% of all cancer cases.[24]

United Kingdom

Kidney cancer is the eighth most common cancer in the UK (around 10,100 people were diagnosed with the disease in 2011), and it is the fourteenth most common cause of cancer death (around 4,300 people died in 2012).[25]

See also

References

  1. ^ Mulders PF, Brouwers AH, Hulsbergen-van der Kaa CA, van Lin EN, Osanto S, de Mulder PH. [Guideline 'Renal cell carcinoma']. Ned Tijdschr Geneeskd. February 2008, 152 (7): 376–80. PMID 18380384 （Dutch; Flemish）. 
  2. ^ SEER Stat Fact Sheets: Kidney and Renal Pelvis Cancer. NCI. [18 June 2014]. 
  3. ^ Thyavihally YB, Tongaonkar HB, Desai SB. Benign mixed epithelial stromal tumor of the renal pelvis with exophytic growth: case report. Int Semin Surg Oncol. September 2005, 2: 18. PMC 1215508 可免费查阅. PMID 16150156. doi:10.1186/1477-7800-2-18. 
  4. ^ Nzegwu MA, Aligbe JU, Akintomide GS, Akhigbe AO. Mature cystic renal teratoma in a 25-year-old woman with ipsilateral hydronephrosis, urinary tract infection and spontaneous abortion. Eur J Cancer Care (Engl). May 2007, 16 (3): 300–2. PMID 17508953. doi:10.1111/j.1365-2354.2006.00755.x. 
  5. ^ Chiu KC, Lin MC, Liang YC, Chen CY. Renal carcinosarcoma: case report and review of literature. Ren Fail. 2008, 30 (10): 1034–9. PMID 19016157. doi:10.1080/08860220802403192. 
  6. ^ Kuroda N, Katto K, Tamura M, Shiotsu T, Hes O, Michal M, Nagashima Y, Ohara M, Hirouchi T, Mizuno K, Hayashi Y, Lee GH. Carcinoid tumor of the renal pelvis: consideration on the histogenesis. Pathol. Int. January 2008, 58 (1): 51–4. PMID 18067641. doi:10.1111/j.1440-1827.2007.02188.x. 
  7. ^ Symptoms of kidney cancer : Cancer Research UK : CancerHelp UK
  8. ^ Katie Charles. Kidney cancer: Innovative new treatments boost survival rates for cancer patients: Daily Checkup with Michael Palese. New York Daily News. January 19, 2011 [February 23, 2011]. 
  9. ^ Commonly Used Pain Pills Increase Kidney Cancer Risk in Study. Bloomberg. 
  10. ^ Lipworth, Loren; Robert E. Tarone; Joseph K McLaughlin. The Epidemiology of Renal Cell Carcinoma. Journal of Urology. 13 December 2005, 176 (6): 2353–235 [2012-07-15]. PMID 17085101. doi:10.1016/j.juro.2006.07.130. 
  11. ^ Cheungpasitporn, W; Thongprayoon C; O'Corragain OA; Edmonds PJ; Ungprasert P; Kittanamongkolchai W; Erickson SB. The Risk of Kidney Cancer in Patients with Kidney Stones: A Systematic Review and Meta-analysis. QJM. 9 September 2014, 108: 205–12. PMID 25208892. doi:10.1093/qjmed/hcu195. 
  12. ^ Risks and causes of kidney cancer : Cancer Research UK : CancerHelp UK
  13. ^ Early stage and locally advanced kidney cancer treatment : Cancer Research UK : CancerHelp UK
  14. ^ Advanced kidney cancer : Cancer Research UK : CancerHelp UK
  15. ^ List of treatments for kidney cancer
  16. ^ NCCN kidney cancer guidelines
  17. ^ Biological therapy for kidney cancer : Cancer Research UK : CancerHelp UK
  18. ^ Jonasch, Eric; Messner, Carolyn. CancerCare Connect - Treatment Update: Kidney Cancer (PDF). Cancer Care, Inc. August 2012 [2012-08-29]. 
  19. ^ 19.0 19.1 Wilms' tumour (kidney cancer in children) : Cancer Research UK : CancerHelp UK
  20. ^ Lindblad, P. and Adami H.O, Kidney Cancer, in Textbook of Cancer.
  21. ^ GLOBOCAN 2002, Cancer Incidence, Mortality and Prevalence Worldwide 2002 estimates. 2006.
  22. ^ Cancer of the Kidney and Renal Pelvis - SEER Stat Fact Sheets. National Cancer Institute, U.S. National Institutes of Health. [2013-02-07]. 
  23. ^ Lynch, Charles F.; West, Michele M.; Davila, Jessica A.; Platz, Charles E. Chapter 24: Cancers of the Kidney and Renal Pelvic. Ries, LAG; Young, JL; Keel, GE; Eisner, MP; Horner, M-J (编). SEER Survival Monograph: Cancer Survival Among Adults: US SEER Program, 1988-2001, Patient and Tumor Characteristics. SEER Program. NIH Pub. No. 07-6215. Bethesda, MD: National Cancer Institute. 2007: 193–202. 
  24. ^ Ferlay J.; et al. Estimates of the cancer incidence and mortality in Europe in 2006. Annals of Oncology. 2007, 18 (3): 581–92. doi:10.1093/annonc/mdl498. 
  25. ^ Kidney cancer statistics. Cancer Research UK. [27 October 2014]. 
检索自“https://zh.wikipedia.org/zhwiki/w/index.php?title=腎癌&oldid=36108104”