Tumor embrionario renal

　　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 occur distant metastasis early, with the same metastasis pathways as renal cell carcinoma, often metastasizing to lung, liver, bones, etc. The tumor composition is diverse, in addition to the spheroidal arrangement of embryonic germ cells and the formation of幼稚的 renal glomeruli or renal tubular structures, there are loose mucinous tissue in the stroma, and sometimes there are striated muscle, cartilage, bone, or fat tissue. The occurrence of renal embryonal tumor is related to11p13of WT-1loss of or mutation of genes related.

　　Renal embryonal tumor can be spread hematogenously to lung, liver, bone, brain, etc. There is12% to15% of children may have congenital malformations, such as congenital iris choroidal defect, duplicated kidney, horseshoe kidney, polycystic kidney, ectopic kidney, visceral hypertrophy, umbilical hernia, macroglossia, hemihypertrophy, etc. The clinical manifestations of adult renal embryonal tumors 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 and is discovered during the routine physical examination by family members and doctors, common symptoms include abdominal pain, distension, 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 is NWTS3The staging method, the tumor staging is:

　　Stage Ⅰ: The tumor is limited to the kidney and can be completely resected; 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 resected; 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 exudation 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, tumor metastasis is found in renal hilum or para-aortic lymph nodes by histological examination, and there is extensive tumor infiltration in the abdominal cavity; There is tumor implantation in the peritoneum, and there is tumor residue at the resection margin observed grossly or under the microscope; Due to the infiltration of surrounding important tissues, the tumor could not be completely resected.

　　Stage Ⅳ: There is hematogenous metastasis, 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-stage patients, the five-year survival rate is9More than 0%. However, the five-year survival rate for children with simple surgery or late-stage disease is not ideal. For patients who have not recurred after five years of treatment, the chance of recurrence in the future is greatly reduced.

　　Para la enfermedad renal embrionaria, es recomendable comer alimentos que puedan combatir los tumores renales, como tortugas, tortugas marinas, caballos marinos, gusanos marinos, serpientes reales, aceite de ballena, medusas, calamares, médula ósea de cerdo y vaca, acénero, higos, hierbas amargas, pepinos, papayas, arroz glutinoso, polillas, naranjas, hojas de sophora.

　　Para la enfermedad renal embrionaria, es recomendable comer alimentos que refuercen la constitución y aumenten la inmunidad, como sardinas, camarones, peces azules, anguillas, almejas marinas, ostras, hígado de cerdo y riñones de cerdo, shiitake, lentejas, nogales, manzanas, kiwis, judías verdes, judías rojas, cordón umbilical, miel de abeja, semillas de sésamo.

　　Para la enfermedad renal embrionaria, es recomendable comer sapos, noni, arroz glutinoso, cilantro, médula ósea de cerdo y vaca, judías verdes, nogales, riñones de cerdo y vaca, abulones, cangrejos, serpientes marinas, almejas marinas, algas marinadas.

　　El tumor embrionario renal también es como el cáncer renal, una vez diagnosticado, debe realizarse una nefrectomía abdominal lo antes posible. Para tumores muy grandes, se puede realizar radioterapia primero para reducir el tamaño del tumor, lo que facilita la cirugía, puede reducir la hemorragia y reducir la dificultad de la cirugía. Después de que la herida quirúrgica se cure, se puede comenzar a continuar la radioterapia, lo que puede aumentar la tasa de curación. La quimioterapia puede usar actinomycin D15~25microgramos/kilogramos/día, usar consecutivamente5días, inyectado por vía intravenosa, después cada3meses para repetir, en total7vez. O acetaína de vinblastina40 ~60 microgramos/kilogramos/día, administrado por vía intravenosa, con una dosis total de100 ~300 microgramos/kilogramos.

　　Bajo la aplicación conjunta de cirugía, radioterapia y quimioterapia, la tasa de supervivencia a largo plazo del tumor embrionario renal ha mejorado significativamente. Si es un paciente en una etapa temprana, la tasa de supervivencia a cinco años es90% en adelante. Pero para los niños con cirugía simple o enfermedad avanzada, la tasa de supervivencia a cinco años es muy desfavorable. La posibilidad de recurrencia después de cinco años sin recurrencia después del tratamiento es significativamente menor.