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| 膀胱非尿路上皮癌的临床特点和预后分析(附31例报告) |
| 陈新1Δ,宋瑞祥1Δ,曾蜀雄1,马重1,张振声1,侯建国1,林天歆2,黄健2,孙颖浩1,许传亮1* |
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(1. 第二军医大学长海医院泌尿外科, 上海 200433;
2. 中山大学孙逸仙纪念医院, 广州 510000
△共同第一作者
*通信作者) |
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| 摘要: |
| 目的：探讨膀胱非尿路上皮癌的临床特点、治疗方式及预后。方法：回顾性分析我院31例病理确诊为膀胱非尿路上皮癌的患者（其中26例男性，5例女性，年龄31-84岁，平均年龄61岁）的临床资料，对病人的初诊症状、肿瘤数量大小部位、术前和术后病理、手术方式、化疗或放疗方案进行记录，并就患者复发进展及生存等情况进行随访。结果：31人中初诊症状肉眼血尿为主，占77.4%。肿瘤位置最常见于左右侧壁，单发和多发比例相近，肿瘤大于3cm的有20例，占64.5%。行膀胱全切术18例，膀胱部分切除术4例，TURBT 6例，放弃手术治疗3例。病理结果为腺癌16例（占51.6%），鳞癌8例（占25.8%），肉瘤3例，小细胞癌、腺鳞癌各2例。术后29例（2例失访）随访2-62m，腺癌的中位生存期为23m，鳞癌的为15m，其他类型为26m。行全膀胱手术的患者中位生存期为24m，高于其他治疗方式的20m。结论：膀胱非尿路上皮癌，多以肉眼血尿为初诊症状，肿瘤较大，多位于左右侧壁，预后与治疗方式及病理结果关系密切。化疗及放疗的效果较为有限，早期行根治手术有助于改善预后。 |
| 关键词: 膀胱肿瘤 非尿路上皮癌 临床特点 预后 |
| DOI：10.16781/j.0258-879x.2016.02.0262 |
| 投稿时间：2015-09-07修订日期：2015-10-23 |
| 基金项目: |
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| Analysis of clinical characteristics and prognosis of non-urothelial carcinoma of bladder: a report of 31 cases |
| CHEN Xin1Δ,SONG Rui-xiang1Δ,ZENG Shu-xiong1,MA Chong1,ZHANG Zhen-sheng1,HOU Jian-guo1,LIN Tian-xin2,HUANG Jian2,SUN Ying-hao1,XU Chuan-liang1* |
(1. Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;
2. Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510000, Guangdong, China
△Co-first authors
* Corresponding author) |
| Abstract: |
| Objectives: The aim was to investigate the clinical features, treatments and prognosis of non- urothelial carcinoma of urinary bladder. Materials and Methods: A total of 31 patients with non-transitional bladder cancer from June 2009 and April 2015 in our hospital were retrospectively evaluated in this study, of whom 26 males and 5 females, aged from 31 to 84 years, average age was 61 years. The patients’ characteristics, including symptoms, tumor number, size, and localization, pathological types before and after the operation, treatments, recurrence and survival rates were all follow up and recorded. Results: 77.4% of the preliminary symptoms among these 31 patients were gross hematuresis, Tumor most commonly located in left or right lateral wall of bladder. Mono-tumor and multi-tumor in the bladder have similar proportion. There are 20 cases of tumors larger than 3cm, accounted for 64.5%. 18 patients underwent radical cystectomy，4 patients underwent partial cystectomy ,6 patients underwent transurethral resection of bladder tumor and 3 patients gave up operation. Of these tumors, 16(51.6%) were cases of adenocarcinoma, 8 (25.8%) squamous cell carcinoma ,3 sarcoma,2 small cell carcinoma , 2 adenosquamous. 29 patients were followed up for 2 to 62 months(2 cases were lost to follow-up)．Median survival for adenocarcinoma patients is 23m, squamous cell carcinoma patients is 15m, andother histological types is 26m. Median survival for patients treated by radical cystectomy is 24m, higher than 20m of others. Conclusion: Non- urothelial carcinoma of the urinary bladder, with the most commom preliminary symptoms of gross hematuresis, located mostly in left or right lateral wall of bladder, and the size of the tumors were often larger. Prognosis of urinary bladder tumors was directly related to histological type and therapy method. The effect of chemotherapy and radiation is limited. Early radical cystectomy should be performed to improve prognosis. |
| Key words: urinary bladder neoplasms non-urothelial carcinoma clinical characteristics prognosis |
