Nierengemischter Tumor

　　Renal embryonal tumor is a malignant mixed tumor composed of epithelium and stroma, usually a large solid tumor, with a capsule outside and containing various tissues such as glands, nerves, muscles, light bones, and fat. The tumor grows very fast, highly malignant, and can have distant metastases early, with the same metastatic pathways as renal cell carcinoma, often metastasizing to the lung, liver, and bones. The tumor composition is diverse, in addition to the reticulated arrangement of embryonic germ cells and the formation of immature glomerular or tubular structures, loose mucinous tissue can be seen in the stroma, and sometimes striated muscle, cartilage, bone, or fat tissue can also be seen. The occurrence of renal embryonal tumor is related to11p13of WT-1loss of or mutation of genes related.

　　Renal embryonal tumor can be metastasized hematogenously to lung, liver, bone, brain, etc. There are12% to15% of children may have congenital malformations, such as congenital iris choroid defect, duplicated kidney, horseshoe kidney, polycystic kidney, ectopic kidney, visceral hypertrophy, umbilical hernia, macrostomia, hemihypertrophy. The clinical manifestations of adult renal embryonal tumor are similar to those of renal cell carcinoma patients, and may be accompanied by asymptomatic hematuria, lumbar pain, abdominal mass, and other manifestations.

　　Renal embryonal tumor is often asymptomatic mass discovered by family members and doctors during routine physical examination, common symptoms include abdominal pain, bloating, anorexia, nausea and vomiting, fever, hematuria, etc., common signs include abdominal mass, about25% to60% of patients have hypertension, which may be related to increased renin levels, tumor staging: NWTS staging is mainly based on surgical treatment and pathological findings, and the most widely used at present is NWTS3The staging method, the tumor staging is:

　　Stage I: The tumor is confined to the kidney and can be completely removed; there is no ulceration before or during surgery, and there is no tumor residue at the resection margin.

　　Stage II: The tumor has spread outside the kidney and can be completely removed; there is limited spread, such as the tumor has penetrated the renal capsule to the surrounding soft tissue; there are tumor emboli or tumor infiltration in the extrarenal blood vessels; there has been a biopsy or tumor escape found during surgery, but it is limited to the lumbar region, and there is no obvious tumor residue at the resection margin.

　　Stage III: There is non-hematogenous tumor residue in the abdomen, and tumor metastasis is found in renal hilum or para-aortic lymph nodes by biopsy; there is extensive tumor infiltration in the peritoneal cavity; there is tumor implantation in the peritoneum, and tumor residue is observed at the resection margin under gross or microscopic observation; due to infiltration around important tissues, the tumor cannot be completely removed.

　　Stage IV: There are hematogenous metastases, such as lung, liver, bone, brain, etc.

　　The etiology of renal embryonal tumor is unknown, and there is no special prevention. Under the combined application of surgery, radiotherapy, and chemotherapy, the long-term survival rate of renal embryonal tumor has been significantly improved. For early patients, the five-year survival rate is9Above 0%. However, for children with simple surgery or late disease course, the five-year survival rate is not ideal. For patients who have not复发 in five years after treatment, the chance of recurrence in the future is greatly reduced.

　　Die Ernährung von Nierenblastom sollte mehr Lebensmittel essen, die gegen Nierenkrebs wirken, wie Kröten, Seeigel, Seehufe, Sandkrebse,眼镜王蛇, Orangensaft, Seetang, Seepocken, Seescheiden, Seetang, Feigen, Weizengras, Ma, Apfel, Acai, Dolichos, Adstringens, Honig, Sesam.

　　Die Ernährung von Nierenblastom sollte mehr Lebensmittel essen, die die Gesundheit stärken und das Immunsystem stärken, wie Sardinen, Garnelen, Seefische, Aale, Seetang, Muscheln, Leber, Nieren, Eier, Lotus, Mandeln, Äpfel, Acai, Dolichos, Adstringens, Honig, Sesam.

　　Die Ernährung von Nierenblastom sollte Krabben, Noni, Job's tears, Coriander, Rind- und Kalbfleischknochen, Dolichos, Mandeln, Schweine- und Rindernieren, Abalones, Kraken, Meeresschlange, Seetang, Seepocken, Seescheiden, Seetang, Feigen, Weizengras, Ma, Apfel, Acai, Dolichos, Adstringens, Honig, Sesam.

　　Nierenblastom ist auch wie Nierenkrebs, sobald diagnostiziert, sollte so früh wie möglich eine nephrectomie durch die Bauchhöhle durchgeführt werden. Bei übermäßig großen Tumoren kann vor der Operation eine Bestrahlung vorgenommen werden, um die Tumorgröße zu verringern, was die Operation erleichtert, das Blutungsrisiko verringert und die Operationsschwierigkeit senkt. Nach der Wundheilung kann die Bestrahlung fortgesetzt werden, was die Heilungsraten erhöhen kann. Chemotherapie kann Actinomycin D verwenden.15～25Mikrogramm/Kilogramm/Tag, kontinuierlich5Tag, intravenös injiziert, danach alle3Monat wiederholen, insgesamt7mal. Oder Vinblastin40～60 Mikrogramm/Kilogramm/Tag, intravenös verabreicht, die Gesamtdosis beträgt100～300 Mikrogramm/Kilogramm.

　　Unter der kombinierten Anwendung von Operation, Bestrahlung und Chemotherapie hat die langfristige Überlebensrate von Nierenblastom erheblich zugenommen. Bei frühen Patienten liegt die Fünfjahresüberlebensrate bei9Über 0％. Aber für Kinder mit rein chirurgischer Behandlung oder fortgeschrittener Krankheitsentwicklung ist die Fünfjahresüberlebensrate nicht sehr gut. Die Wahrscheinlichkeit einer Rezidivierung nach fünf Jahren nach der Behandlung ist erheblich verringert.