你有什么类型的肾癌？

肾脏位于脊柱两侧的腹部器官后面。他们发挥了过滤的关键作用，然后在尿液中冲洗废物。当肾癌剧烈时，较大的肿瘤有时会导致尿液中的血液，或在一侧引起腰部疼痛。尽管如此，很多人都没有症状。在洛杉矶大学加利福尼亚大学肾癌计划主任Brian Shuch表示，当医生正在寻找别的东西时，通常会发现肿瘤。

Again, 9 out of 10 kidney cancers are diagnosed as renal cell carcinoma (RCC), where cancerous cells grow in the lining of the kidney’s tubules (small tubes that help filter blood, excrete waste, and make urine). There are actually three different kinds of RCC, according to the ACS. Most common isclear cell RCC(named for tumor cells that looked like clear bubbles), which comprises roughly 75% of all RCC cases.乳头状RCC.(named for cancer cells with fingerlike projections) makes up 13% to 20%, withchromophobe RCCdiagnosed in 5% of RCCs. A few super-rare, unclassified RCCs are occasionally diagnosed, too.

When RCC is caught early enough (before it metastasizes, or spreads beyond the kidney), surgical removal of the cancerous kidney (a procedure known as nephrectomy) is often the main treatment—and it can be the cure. Another treatment is ablation, which destroys cancer cells by freezing or burning them. Ablation has low side effects and can be given as an outpatient procedure. Still, the cure rate from a single ablation may not be as high as surgical removal. Plus, not all tumors are suitable for ablation, according to Johns Hopkins.

For stage 4 (metastatic) RCC, surgery and radiation together can be effective. Plus, advanced clear cell RCC often responds well to systemic treatments, including chemotherapy and immunotherapy (the latter deploys the body’s own immune system to fight cancer cells), as well as targeted therapy, which uses drugs to go after specific genes involved in cancer-cell growth. However, RCCs may develop resistance to treatment and may return locally—but some recurring cancers can be treated effectively with surgery plus systemic therapies, according to CancerConnect.

Urothelial carcinomais among the 10% of kidney cancers that arenotRCC. “Urothelial carcinomas are very different from renal cell carcinomas,” says Pavlos Msaouel, M.D., assistant professor of Genitourinary Medical Oncology at MD Anderson Cancer Center in Houston. “They’re managed differently and have different prognostic considerations.” This cancer targets cells inside the urethra and the ureter (the tube connecting the bladder with the kidney). Most UCs grow in the bladder, but it’s considered kidney cancer when it's found in the renal pelvis or high up in the ureter, he explains.

RCC和UC有时也可以共享类似的症状，如尿液中的血液。然而，“如果尿路上皮癌从尿道或膀胱中出现，那么它可以产生症状，例如尿液阻塞，这很少被RCC看，”Msaouel博士说。如果您有弱或中断的流或腹部疼痛，您的医生会给您超声波或CT扫描，看看UC障碍是否责备。

Treatment for UC is determined by its stage. For stage 0, a transurethral resection (TUR), where a doctor inserts a cystoscope to remove the mass, may be all that is needed. For a stage 1 tumor, a TUR, followed by chemotherapy, is standard. While chemo doesn’t work well against most RCCs, “it’s a time-honored therapy for urothelial carcinoma,” says Dr. Msaouel. Stages 2 and 3 often require a partial or total removal of the bladder, followed by chemo. For stage 4, chemo and immunotherapy are the main treatments; targeted therapy is also sometimes considered.

Kidney sarcomamakes up fewer than 1% of all kidney cancer cases, explains Dr. Msaouel. Acarcinomagrows in the cells that line the body’s internal organs (or in the skin). Asarcomagrows in the body’s connective tissue, including fat, muscles, and deep skin tissues. Kidney sarcoma develops in the connective tissue or fat surrounding the kidney. Due to the very aggressive nature of the tumor, kidney sarcoma is often diagnosed quite late, requiring surgery and chemotherapy.

科学家不确定肾肉瘤的原因是什么，但研究发现软组织肉瘤中的DNA突变很常见。根据ACS，被认为在生命期间被认为在生命中获得癌症引起的化学品或辐射，而不是在出生前遗传。这种癌症通常用手术治疗 - 如果恢复，通常会用手术或手术和化疗。因为肾脏肉瘤往往会迅速生长并产生难以完全去除的大肿瘤，可能是转移和再次发生。

Wilms tumorShuch博士说，是一种肾癌，主要是在2和5岁之间的儿童发展。几乎所有病例都在10岁之前诊断出10岁。根据Medline数据，群体的发病率因人群而异，“由于未知的原因，非洲裔美国人的风险高于平均水平。”在体育考试期间，通常首先注意到Wilms肿瘤作为肾脏肿胀或肾脏中的肿块。其他可能的症状包括发烧，恶心，食欲丧失，尿液中的血液

基于阶段确定威尔斯肿瘤的治疗以及活检细胞如何在显微镜下方看。还考虑肿瘤大小，孩子的年龄和任何DNA变化。手术通常是一线方法，目的是除了癌症的蔓延。在第3阶段，肿瘤不再完全除去，所以使用化疗before手术缩小癌症。甚至具有晚期肿瘤的儿童甚至有4年生存率为85％至100％。

According to the National Institutes of Health,primary renal lymphoma(PRL)被定义为一个非霍奇金淋巴瘤不ving the kidney. “In very rare cases, lymphoma may arise from the kidneys,” says Dr. Msaouel. (It’s so rare, its very existence has been debated in the past, although as of 2016 up to 70 cases were reported.) PRL usually presents as a lone tumor mass in the kidney and may include enlarged regional lymph nodes. When it strikes, “the disease should be managed more like a lymphoma and not like a renal cell carcinoma or a sarcoma,” he explains.

Some good news:良性肿瘤don’t have the ability to metastasize. Still, these tumors are often removed, anyway. UCLA Health describes three different kinds of benign kidney tumors, includingrenal adenoma(a small, slow-growing mass of less than 1 cm);鼻细胞瘤(a non-spreading renal tumor that can resemble kidney cancer on a biopsy); andangiomyolipoma(a tumor containing fat, vessels, and muscle). Larger benign tumors can bleed, so treatment is advised when they are more than 4 cm (the size of a large walnut)—surgical removal of the affected kidney is usually performed.

Obviously, if you find blood in your urine, call your doctor right away and ask to be screened for kidney cancer (although this symptom can certainly mean other things, too). If youarediagnosed with kidney cancer—any of the types described here—it may come as a total surprise, since many people never experience anything other than lower back pain as a warning sign. But know this: Dr. Msaouel reassures that when caught early, most renal cell carcinomas (remember—that’s 90% of all cases) are treated successfully—and have very good prognoses.