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Журнал "Медицина невідкладних станів" 8 (63) 2014

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Etiopathogenesis of renal cell cancer

Автори: Vinnik J.O., Zelenskiy R. - Kharkiv Regional Cancer Center klinchnyy

Рубрики: Медицина невідкладних станів

Розділи: Довідник фахівця

Версія для друку

Ключові слова

renal-cell cancer, review.

Summary. According to current data, renal cell carcinoma (NCC) is a Polyetiological disease, the emergence and development which may affect many completely different influence factors: genetic, hormonal, chemical, radiation, immunology and others.

Definite causes of kidney tumors was not significantly determined. Specific carcinogen were found. Risk factors include smoking, kidney injury, contact with nytrozosoedynenyy, cyclic hydrocarbons and asbestos, as well as abuse of analgesic drugs, long-term hemodialysis (in patients with chronic renal failure) and some diseases that lead to nephrosclerosis (including hypertension, diabetes, nephrolithiasis, chronic pyelonephritis, etc.). Judging the dynamics of tumor growth buds can be a number of observations: 1 The diagnosis of tumors of the kidney was made, the nature of CT data accumulation of contrast medium showed a possibly malignant tumor of the kidney, but because of the small size of the tumors was decided to hold the operation and implement dynamic monitoring. Strongly approve of such tactics, but with regret to observe these patients, who have to operate at an advanced stage of the disease. 2 The diagnosis of tumors are likely malignant, no doubt, but the operation was decided to stay because of patient age (over 80 years). 3 The operation could not hold due to severe comorbidities.

Thus, latent disease complicates early diagnosis of tumors, but our experience, these observations even late diagnosis can count on successful result.

Morphogenesis of renal cell cancer include: development of more diffuse nephrosclerosis; appearance Focus sclerosis precancerous changes in the form of focal epithelial hyperplasia nefrotsytiv with the emergence of dysplasia, accompanied by genetic instability and genomic damage epithelial cells; epithelial origin of small renal tumors, some of which are first renal cell cancer, and others - adenomas; tumor progression with the growing heterogeneity of tumor clones detected in the study of DNA.

Thus, the growth of the tumor and its size reaching more than 5.5 cm in most tumors cell necrosis and hemorrhage. Decay products of tumor entering the bloodstream, causing a general reaction - intoxication and fever, bone marrow suppression and decreased immunity. With the growth of tumors spreading intrarenal, in intrarenalnoho veins and lymph vessels, which leads to multifocal tumor growth. It is possible that regardless of the primary tumor may form new cells independent of tumor growth. Tumor increases and extends through intrarenalnyh veins, venous forming micrometastases. Perhaps in most cases (90% or more) in the kidney that is affected by the tumor is microscopic venous invasion and multifocal tumor growth, however, due to their small size can not be detected clinically and even with routine morphological study.

Thus, the problem of kidney cancer remains one of the most important in oncourology. Among onkourolohicheskih disease kidney cancer ranks third after bladder cancer and prostate cancer, and death in the first place. Long-term monitoring of changes in the frequency of the disease, the degree of neglect, as well as the life expectancy of patients provide a basis to predict the incidence and survival of patients with renal cell carcinoma. Number of patients with locally process in the kidney is in Ukraine, according to the literature, about 40%. It is interesting dynamics and reasons for abandonment kidney cancer, as well as a number of advanced forms remains high, it is important identify ways of prevention and early diagnosis for timely identification and selection of optimal treatment.Key words: renal cell carcinoma, a review of the literature.

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