小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 无症状（意外发现）
- 血尿
- 腰部疼痛
- 可触及腹部包块
其他诊断因素
- 非特异性系统性症状
- 肝功能障碍的体征
- 神经肌病
- 下肢水肿
- 阴囊精索静脉曲张
- 皮肤病学表现（遗传性综合征）
- 视力丧失 (von Hippel Lindau综合征)
危险因素
- 吸烟
- 男性
- 年龄超过 55 岁
- 居住在发达国家
- 黑种人/美洲印第安族裔
- 肥胖
- 高血压
- RCC 家族史阳性
- 遗传性综合征病史
- 获得性囊性肾病病史
- 石棉/镉
- 产科历史/雌激素暴露
- 盆腔放疗
诊断性检查
首要检查
- 全血细胞计数（FBC）
- LDH
- 矫正钙
- 肝功能检测
- 凝血指标
- 肌酐
- 估算的 GFR
- 尿液分析
- 腹部/盆腔超声
- 腹部/盆腔 CT
- 腹部/骨盆 MRI
需考虑的检查
- 胸部 CT
- 脑部/脊柱 MRI
- 骨扫描
- 活检
- 外科病理学
新兴检查
- PET 扫描
治疗流程
肾脏小肿块或 RCC 1 期或 2 期
RCC 3 期
RCC 4 期（转移性疾病）
撰稿人
作者
Rodrigo R. Pessoa, MD, PhD
Urology physician
Anshutz Medical Campus
University of Colorado
UCASOM Division of Urology
Denver
CO
利益声明
RRP declares that he has no competing interests.
Simon Kim, MD, MPH
Associate Professor of Surgery
Associate Program Director
Anschutz Medical Campus
University of Colorado
UCSOM Division of Urology
Denver
CO
利益声明
SK declares that he has no competing interests.
鸣谢
Dr Rodrigo R. Pessoa and Dr Simon Kim would like to gratefully acknowledge Dr Amishi Y. Shah, Dr Sonal Gandhi, and Jennifer J. Knox, previous contributors to this topic.
利益声明
AYS has an unpaid advisory role for Merck pharmaceuticals. SG and JJK declare that they have no competing interests.
同行评议者
Stephen A. Boorjian, MD
Assistant Professor
Fox Chase Cancer Center
Philadelphia
PA
利益声明
SAB has been reimbursed by Pfizer for serving on its speakers bureau. SAB is co-author of a reference cited in this topic.
Thomas J. Guzzo, MD, MPH
Assistant Professor of Urology and Surgery
The Hospital of the University of Pennsylvania
Philadelphia
PA
利益声明
TJG declares that he has no competing interests.
Jonathan Waxman, BSc, MBBS, MD, FRCP
Professor of Oncology
Imperial College
London
UK
利益声明
JW declares that he has no competing interests.
鉴别诊断
- 良性肾囊肿
- 输尿管癌
- 膀胱癌
更多 鉴别诊断指南
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- 晚期肾癌的管理
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