中国实用儿科杂志

中国实用儿科杂志 ›› 2026, Vol. 41 ›› Issue (2): 160-165.DOI: 10.19538/j.ek2026020615

• 论著 • 上一篇    下一篇

儿童肾脏恶性肿瘤 42 例临床分析

  

  1. 1.郑州大学附属儿童医院  河南省儿童医院  郑州儿童医院血液肿瘤科，河南  郑州  450018 ；2.首都医科大学附属北京儿童医院血液肿瘤中心，北京  100045
  • 出版日期:2026-02-06 发布日期:2026-03-13
  • 通讯作者: 王天有，电子信箱：wangtianyou@bch.com.cn

Pediatric renal malignancies：a clinical analysis of 42 cases

  1. *Department of Hematology and Oncology，Children’s Hospital Affiliated to Zhengzhou University，Henan Children’s Hospital，Zhengzhou Children’s Hospital，Zhengzhou  450018，China
  • Online:2026-02-06 Published:2026-03-13

摘要： 目的　探讨儿童肾脏恶性肿瘤的临床特点、治疗、预后及其影响因素。方法　回顾性分析2020年1月至2023年12月郑州大学附属儿童医院血液肿瘤科收治的初治肾脏恶性肿瘤患儿的临床资料，所有患儿均接受中国小儿肿瘤专业委员会（CCCG）肾母细胞瘤（WT）-2019方案（CCCG-WT-2019）治疗，分析患儿年龄、性别、症状、体征、肾组织病理、治疗转归等。采用基于 Kaplan-Meier 曲线的累积生存估计方法进行生存分析，采用Kaplan-Meier 曲线联合 Log-rank 检验描绘和比较不同组别之间的预后差异。结果　共纳入42例患儿，男性22例，女性20例，中位年龄为24（4.3~87）个月。左肾23例，右肾17例，双肾2例。预后良好型肾母细胞瘤（FHWT）37例，肾透明细胞肉瘤（CCSK）3例，肾横纹肌样瘤（MRTK）2例。Ⅰ期9例，Ⅱ期17例，Ⅲ期8例，Ⅳ期6例，Ⅴ期2例。共13例需放疗，12例完成放疗。随访2.27~54.03个月，中位随访时间38个月，3年累积总生存率和无事件生存率分别为97.561%、95.238%。将性别、年龄、原发灶位置、病理类型、分期、有无放疗6个组别纳入预后单因素分析，发现病理类型与预后具有相关性（P<0.001）。结论　CCCG-WT-2019方案治疗儿童肾脏恶性肿瘤具有较好疗效，病理类型与疾病预后存在相关性。

关键词: 恶性, 肾肿瘤, 儿童, 临床特征, 预后

Abstract: Objective　To investigate the clinical characteristics，treatment，prognosis，and influencing factors of pediatric renal malignant tumors. Methods　A retrospective analysis was conducted on the clinical data of children with newly diagnosed renal malignant tumors treated in Department of Hematology and Oncology，Children’s Hospital Affiliated to Zhengzhou University from January 2020 to December 2023.All patients received the CCCG-WT-2019 regimen （Wilms tumor protocol established by the Chinese Children’s Cancer Group）， and clinical data including age， sex, symptoms， physical signs， histopathology， and treatment outcomes were analyzed.Survival analysis was performed using the Kaplan-Meier curve-based cumulative survival estimation method.The Kaplan-Meier curve combined with the Log-rank test was used to depict and compare the prognostic differences among different groups. Results　A total of 42 patients were included，comprising 22 males and 20 females，with ages ranging from 4 months and 8 days to 7 years and 3 months，and a median age of 24 months.The tumors were located in the left kidney in 23 cases，the right kidney in 17 cases，and both kidneys in 2 cases.Pathological types included favorable-histology Wilms’ tumor（FHWT）in 37 cases，clear cell sarcoma of the kidney（CCSK）in 3 cases，and malignant rhabdoid tumor of the kidney（MRTK）in 2 cases.The disease stages were as follows：Stage Ⅰ in 9 cases，Stage Ⅱ in 17 cases，Stage Ⅲ in 8 cases，Stage Ⅳ in 6 cases，and Stage V in 2 cases.A total of 13 patients required radiotherapy，with 12 completing the treatment.The median follow-up time was 2.27-54.03 months（median 38 months），and the 3-year event-free survival（EFS）rate and overall survival（OS）rate were 95.238% and 97.561%，respectively.Univariate analysis of prognostic factors，including gender，age，primary tumor location，pathological type，disease stage，and radiotherapy，revealed a significant correlation between pathological type and prognosis（P<0.001）. Conclusion　The CCCG-WT-2019 has shown significant efficacy in the treatment of pediatric renal malignant tumors.Pathological type is significantly correlated with disease prognosis.

Key words: malignant, kidney tumors, child, clinical features, prognosis