目的：探讨乳头状肾细胞癌（papillary renal cell carcinoma，PRCC）以及PRCC合并癌栓患者的临床病理特点、治疗及预后。方法：回顾性分析单中心2012年1月至2017年10月收治的75例PRCC的病例，其中男性55例，女性20例，年龄24~82岁，合并癌栓的患者16例，所有病例均为手术患者，病理诊断明确，随访数据完整。总结分析PRCC以及合并癌栓患者的临床病理特点、预后及影响因素。结果：75例患者平均年龄（56.05±11.59）岁，平均体重指数（26±3） kg/m2，肿瘤平均最大径(5.17±3.85) cm，肿瘤最大径是否大于7 cm（69.6%vs.94.4%，P<0.001），有无淋巴结转移（<38%vs.98%，P<0.001）、有无肾上腺转移（0% vs.95.3%，P<0.001）、有无肺转移（0% vs.90.7%，P<0.001）、是否合并癌栓（<66.4%vs.93.5%，P<0.001）对PRCC患者3年生存率的影响差异有统计学意义。本研究患者中，合并癌栓患者16例，16例患者均为2型PRCC。合并癌栓的患者在有无伴随症状（62.5% vs. 22%，P=0.005）、肿瘤最大径（68.8% vs.13.3%，P<0.001）、有无肾上腺转移（18.8% vs.0.02%， P=0.029）、有无肺转移（18.8% vs.0%，P=0.008）、核分级（P<0.001）以及病理分型（100% vs.44.1%，P<0.001）方面，与不合并癌栓患者的差异有统计学意义。结论：肿瘤最大径、淋巴结转移、肾上腺转移、肺转移、是否合并癌栓是PRCC患者3年生存率的影响因素;本研究中合并癌栓的PRCC患者均为2型，肿瘤直径更大、核分级更高、更容易发生远处转移。

Objective： To investigate the clinicopathological features，treatment and prognosis of patients with papillary renal cell carcinoma (PRCC) and PRCC-complicated with tumor thrombus. Me-thods: Single center retrospective analysis of 75 patients with PRCC treated from January 2012 to October 2017 was performed. There were 55 males and 20 females at an age range of 24-82 years. Sixteen PRCC patients were complicated with tumor thrombus. All the patients were with a surgery and had clear pathological diagnosis and detailed follow-up data. The clinicopathological features，prognosis and influencing factors of the patients with PRCC and PRCC complicated with tumor thrombus were analyzed and summarized. Results: The average age of the 75 patients was（56.05±11.59）years，the average body mass index (BMI) was （26±3） kg/m2， and the average tumor maximum diameter was（5.17±3.85）cm. There were significant differences between tumor maximum diameter larger than 7 cm and less than 7 cm （69.6% vs. 94.4%， P<0.001）， lymph node metastasis and no lymph node metastasis （<38% vs. 98%， P<0.001）， adrenal metastasis and no adrenal metastasis （0% vs. 95.3%， P<0.001）， pulmonary metastasis and no pulmonary metastasis （0% vs.90.7%， P<0.001）， complicated with and without tumor thrombus （<66.4% vs. 93.5%， P<0.001） on the effect of 3-year survival rate of the PRCC patients. In this study， there were 16 patients with type 2 PRCC complicated with tumor thrombus. There were significant differences in concomitant symptoms （62.5% vs. 22.0%， P=0.005）， maximum tumor diameter （68.8% vs.13.3%， P<0.001）， adrenal metastasis （18.8% vs. 0.02%， P=0.029）， pulmonary metastasis （18.8% vs. 0%， P=0.008）， nuclear grade （P<0.001） and pathological type （100% vs. 44.1%， P<0.001） between the PRCC patients with  and  without tumor thrombus. Conclusion: There were significant differences in tumor diameter，lymph node metastasis，adrenal metastasis，pulmonary metastasis，pathological type，nuclear grade and tumor thrombus in the effect of the 3year survival rate of PRCC patients. PRCC patients with tumor thrombus were more commonly suffered from type 2 PRCC， for whom the tumor diameter was larger，the nuclear grade was higher，and the distance metastasis happened more easily.