Disease Overview
renalcarcinomais发lifeinrenalsmall管upper皮ofmalignant tumor，isurinarysystemcommonofmalignant tumorone of，accounting foradultsmalignant tumorof2%-3%。peak age of onset50-70years old，malesincidenceapproximatelyasfemalesof2times。in recent yearsrenalcarcinomaincidenceshowing an upward trend，andenvironmentalchange、examinationmodalityadvanceStep, life extensionlongetc.due toelementhaveclose。renalcarcinomaearly-stagesymptomsinsidious，approximately30%-40%patientsat diagnosisHas developedlifemetastasis，advanced-stagerelatively poor prognosis，5yearsurvival rateapproximately10%-20%。
Major Causes
Smoking：isrenalcarcinomaimportantofrisk factor，Smokingthoseincidence riskisnotSmokingthoseof2-3times。
Obesity：Obesityandrenalcarcinoma发diseaserelated，BMI>30kg/㎡thoseincreased risk。
Hypertension：long-termHypertensionpatientsrenalcarcinomaincidence riskincreasing。
Occupational exposure：long-termExposure to cadmium, lead, petroleum products, asbestos,haveOrganic solventsetc.。
Kidney diseases：chronicrenalfunctionnotComplete,long-termbloodDialysis,renalCysts(more囊renal)etc.。
Genetic factors: Family historytyperenalcarcinomaapproximately4%，includingVon Hippel-Lindau (VHL) syndrome、hereditary papillary renal carcinoma、hereditary leiomyomatosis and renal cell cancer(HLRCC)。
radiation exposure：long-termExposure toradiationtype。
Other factors：High-fat diet、Alcohol consumption、certaindrug(long-termenablingusingphenacetin)。
Common Symptoms
hematuria：the most commonsymptoms，approximately70%-80%patients，typicallyasintermittentno痛type肉eyehematuria，alsocanas镜underhematuria。
back pain：lumbarpersistentorparoxysmalDull pain, aching pain,tumorincreaselargeorinvasionsurroundingtissuetimepainaddheavy。
abdominalmass：approximately20%-30%patientscaninupperabdominalorlumbar触andmass, Firmhard，surfacenot规then。
systemicsymptoms：
fever：approximately20%patientsappearing，moreaslowhot, Antilifeelementtreatmentno效
body weightunderdecrease：unexplainedofemaciation、fatigue
anemia: FacialcolorPallor, dizziness,fatigue
Hypertension：tumorcompressionrenalvascularorproducerenalelement，causingBlood pressureelevated。
renalexternalsymptoms(paraneoplastic syndrome)：
polycythemia: Redcellsincreasemore
hypercalcemia: Blood calciumelevated，cancausingpolyuria、polydipsia、nausea
amyloidosis：systemicAmyloidproteinDeposition
metastasissymptoms：
bone pain：bonemetastasiscausing
cough、hemoptysis：pulmonarymetastasis
hepaticenlargement、jaundice：hepaticmetastasis
Pathological Classification
clear cell carcinoma(70%-80%)：most common type，rise源inrenalProximal convolutedsmallTubule,degree of malignancyrelativelyhigh。
papillary renal cell carcinoma(10%-15%)：classified intoⅠtype(prognosisrelativelygood)andⅡtype(relatively poor prognosis)。
chromophobe cell carcinoma(5%-10%)：rise源in集combineTubule,relatively low degree of malignancy。
collecting duct carcinoma：rare，rise源inrenal集combineTubule,high degree of malignancy。
othertype：medullary carcinoma, Not yetminutecarcinoid tumoretc.。
TNM Staging(AJCC8th edition)
Primary Tumor (T)
T1：tumor≤7cm
T1a：tumor≤4cm
T1b：tumor>4cmbut≤7cm
T2：tumor>7cm
T2a：tumor>7cmbut≤10cm
T2b：tumor>10cm
T3：Tumor invadesrenal vein、inferior vena cavaoripsilateraladrenal gland
T3a：Tumor invadesrenal veinoritsminuteBranch,orinvasionrenal周adipose tissue，but未exceedingrenal fascia
T3b：Tumor invadesDiaphragmand belowinferior vena cava
T3c：Tumor invadesDiaphragmand aboveinferior vena cavaorinvasioninferior vena cava壁
T4：Tumor invadesrenal fasciaexternalorinvasionipsilateraladrenal gland
Regional Lymph Nodes (N)
N0：No regional lymph node metastasis
N1：Regional lymph node metastasis present
Distant Metastasis (M)
M0：No distant metastasis
M1：Distant metastasis present
Clinical Stage Grouping
Ⅰstage：T1 N0 M0
Ⅱstage：T2 N0 M0
Ⅲstage：T3 N0-1 M0，T1-2 N1 M0
Ⅳstage：T4anyNM0，anyTN1M1，anyTanyNM1
Diagnosis
Laboratory tests：
血normalRoutine: Hemoglobinprotein, Red blood cellscells、platelet
renalfunction: Serum creatinine, urineelementNitrogen,GFR
Tumor markers：stillno特differenttypeMarker,CEA、CA19-9canelevated
renalexternalmanifestation: Blood calcium, red blood cellscells计number、hepaticfunction
Imaging studies：
ultrasound：preferredInitial screeningmethod，canfoundrenal脏accounting forposition
abdominal contrast-enhanced CT：assessmenttumorsize、invasionextent、lymph nodesmetastasis
renal脏MRI：forsofttissueminute辨ratemorehigh, Suitable forusinginIodinated contrast agent sensitivitythose
PET-CT：usingindistantmetastasisscreening
renalmoveArteriography: When necessarytimeassessmenttumorBlood supply
renalcarcinomaoftreatmentprinciple：
forlocalizedtypeorlocalprogresstype(early-stageormid-stage)renalcarcinomapatientsadoptedwithexternal科surgeryas主oftreatmentmethod，formetastaticrenalcarcinoma(advanced-stage)应adoptedwithin科as主ofcomprehensivetreatmentmethod。minimally invasive interventional therapytreatmenttechnologywithits“minimally invasive”, ”precise“,highly effective”ofcharacteristics，canAsexternal科surgeryofhaveVigorously supplement.
external科Surgical treatment：isrenalcarcinomaofpreferredtreatmentmethod。forearly-stagerenalcarcinomapatientscanadoptednephron-sparing surgery(partial nephrectomy)orradical nephrectomy，canadoptedlaparoscopicortraditionalofopen surgeryperformed。formid-stagerenalcarcinomapatientstypicallyadoptedradical nephrectomy，typicallyadoptedopen surgeryperformed。
minimally invasive interventional therapyablation therapy：foryear老bodyweak、haveexternal科surgerycontraindications, Solitaryrenal、orthoserenallocalresectionrecurrenceofsmallrenalcarcinoma(tumordiameter≤4cm, Especiallyits适usinginexternallifetyperenalcarcinoma)patients，can选usingablation(radiofrequencyablation、microwaveablation、cryoablation、high-intensity focused ultrasound)treatment。
minimally invasive interventional therapyembolizationtreatment：fornotcantoleranceSurgical treatmentofrenalcarcinomapatients，throughvasculartypeinterventional therapyofmethodperformedrenaltumorfeeding arteryembolizationcanrisetocontroltumorgrowth、reliefhematuriasymptomsofeffect，alsocancooperatingexternal科surgerydopreoperativelyembolization，withreduceprocedureinsurgerybleedingrisk。
Prevention and Follow-up
quit smoking and limit alcohol：effectivereduceincidence risk
controlbody weight：BMImaintainin18.5-24.9
treatmentunderlying diseases：controlHypertension、improvementrenalfunctionnot全
healthy diet：reducehighfat、highprotein饮food，moreEat fruits and vegetables
avoidOccupational exposure：addstrong劳moveprotect，avoidExposure to cadmium, asbestosetc.
regularlybodyExamination:high-riskpopulationregularlyperformedrenal ultrasoundexamination
geneticConsultation:havefamily historythoseperformedgenetic testing
follow-up：postoperativelyfirst 2 yearsevery 3-6 monthsfollow-up examination，years 3-5every 6 monthsonce，after 5 yearsannuallyonce