Kidney cancer more common in adult population, is a very high degree of disease malignant disease, clinical stages in medicine has a very important sense, the principles of clinical staging of renal cell carcinoma is a kidney cancer clinical treatment must be followed. Because the choice of treatment according to stage classification more in line with the biological characteristics of renal cell carcinoma, the treatment of blindness and can avoid subjective and arbitrary, selection must be based on different clinical stages of treatment. The most effective immunotherapy method involves staging. Stages of the treatment plan and prognosis has clinical significance.
Western type of kidney cancer:
In pathology, according to the different cell morphology, kidney doctors usually divided into 4 types: clear cell type renal cell carcinoma, granular cell type renal cell carcinoma, mixed cell type renal cell carcinoma, undifferentiated cell type renal cell carcinoma. Clear cell type renal cell carcinoma: cancer cells were polygonal, clear cytoplasm, small and deeply stained nuclei, also known as clear cell carcinoma, a little light for the deterioration of renal cell carcinoma. Granulosa cell type renal cell carcinoma: cube-shaped or polygonal cells, red granular cytoplasm Iraq than clear cell type of malignant cancer cells high, the prognosis is poor.
Mixed cell type renal cell carcinoma of clear cell type renal cell carcinoma and granular cell type RCC mix. Undifferentiated type of kidney cancer: cancer spindle-shaped or irregular in shape, like sarcoma, a higher degree of malignancy. For highly malignant granular cell type and undifferentiated type, treatment is usually combination therapy, as radical nephrectomy and regional lymph node dissection, surgery may be given chemotherapy foreword, renal cell carcinoma after radiotherapy feasible. In order to reduce the recurrence rate, and enhance treatment and improve treatment of negative Western reaction symptoms, usually after surgery supplemented by encouraging Chinese medicine treatment.
In the course of the development period, the Western type of renal cell carcinoma, there are two methods, namely TNM and Robson staging classification.
1 of the Western type of kidney cancer TNM staging: T0 period: no primary tumor. With T1: tumor is small, the same risk of kidney shape, confined within the renal capsule. T1 a period: tumor diameter less than 4cm; T1b tumors larger than 4cm, less than 7cm. T2A period: a large tumor, suffering from kidney deformation, but the tumor is still confined within the renal capsule. T3a tumors invading perirenal fat. T3b tumors invading the vein. T4 tumors had invaded adjacent organs. Followed by lymph nodes and whether there is a remote transfer of classification is in accordance with the development of disease classification. For the lesser degree of deterioration, surgical excision is the preferred method. For a higher degree of deterioration, or remote metastatic disease has emerged, the use of combination therapy, can withstand the surgery for early surgery, chemotherapy, or those who can not afford to radiotherapy, with Chinese medicine treatment or immunotherapy, in order to maximize the elimination of lesions .
TNM staging
Primary tumor (T) stage:
To: no evidence of primary tumor.
T1: tumor diameter less than or equal to 2.5cm, limited to the kidney capsule.
T2: tumor diameter greater than 2 5cm, kidney deformation, the tumor remains in the envelope.
T3a: tumor invasion of perirenal fat.
T3b: Tumor invasion and vein.
T4: the tumor has invaded adjacent organs.
Regional lymph nodes (N) stages:
NX: lymph node metastasis are not sure.
No: lymph node metastasis.
N1: ipsilateral single lymph nodes.
N2: number of regional lymph node involvement.
N3: clear lymph nodes has been fixed in surgery.
N4: close to the regional lymph node involvement.
Distant metastasis (M) phases:
Mx: shift range is not sure.
Mo: no evidence of distant metastasis.
M1: distant metastasis.
Mla: occult metastases.
M1b: the transfer of a single organ.
M1c: a multiple organ transfer.
M1d: Multiple organ metastasis.
(2) RCC Western type of Robson classification mainly on the basis of tumor size and metastasis classification, TNM staging method similar to the treatment, the lower degree of deterioration with surgical resection, the higher degree of deterioration of an integrated therapy.
In general, the treatment of kidney cancer, usually in accordance with progression and metastasis to select the period of treatment, so patients need to clear itself and the Western type of kidney cancer stage. Radical nephrectomy is the most basic method of treatment of renal cell carcinoma, surgical resection of disease include the kidney, perirenal fat, perirenal fascia and the ipsilateral adrenal gland. Radical resection of renal cell carcinoma, while for regional lymph node dissection can be achieved by reducing the local recurrence rate, to help correct the clinical stage and improve survival purposes. For granular cell type, undifferentiated type and a higher degree of deterioration of renal cell carcinoma, surgery should be conditional early surgery, can not afford the surgery, patients should take timely chemotherapy, radiotherapy and combined with the combination therapy of Chinese medicine in order to eliminate the greatest extent lesions, and Western medicine treatment to reduce the negative reaction symptoms.
Robson staging:
Phase I: The tumor is located within the renal capsule.
Phase Ⅱ: tumor invasion of perirenal fat, while still confined to perirenal fascia.
Ⅲ: tumor invasion of the renal vein or regional lymph nodes, with or without inferior vena cava, perirenal fat involvement.
Ⅲ a stage: tumor invasion of the renal vein or inferior vena cava.
Stage Ⅲ b: regional lymph node involvement.
Phase Ⅲ c: involved the renal vein, inferior vena cava, lymph nodes.
Ⅳ: distant metastasis or invasion of adjacent organs.
Ⅳ a stage: In addition to adrenal tumor invasion of adjacent organs.
Ⅳ b of: tumor metastasis.
Pathological type of kidney cancer!
In pathology, according to the different cell morphology, kidney cancer usually divided into 4 types: clear cell type renal cell carcinoma, granular cell type renal cell carcinoma, mixed cell type renal cell carcinoma, undifferentiated cell type renal cell carcinoma.
1, clear cell type renal cell carcinoma: cancer cells were polygonal, clear cytoplasm, small and deeply stained nuclei, also known as clear cell carcinoma, a little light for the deterioration of renal cell carcinoma.
2, granular cell type renal cell carcinoma: cube-shaped or polygonal cells, red granular cytoplasm Iraq, compared with clear cell type of malignant cancer cells is high, the prognosis is poor.
3, mixed cell type renal cell carcinoma: the clear cell type renal cell carcinoma and granular cell type RCC mix.
4, undifferentiated renal cell carcinoma: cancer spindle-shaped or irregular in shape, like sarcoma, a higher degree of malignancy.
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