原发性输尿管移行细胞癌的诊断与治疗(附53例报告)  

Diagnosis and Management of Primary Ureteral Transitional Cell Carcinoma (53 cases report)

作　　者：梁月有[1] 戴宇平[1] 郑克立[1] 梅骅[1] 黄正宇[1] 

机构地区：[1]中山大学附属第一医院泌尿外科,广州市510080

出　　处：《中国肿瘤临床》2005年第1期37-39,共3页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨原发性输尿管移行细胞癌合适的诊断及治疗方法。方法:回顾性分析我院自1995年1月至2003年12月收治的53例输尿管移行细胞癌患者的临床资料。结果:静脉肾盂造影、B超、CT及MRI对本病确诊率分别为3/53、19.1%、82.1%、74.1%。成功行上尿路逆行造影对病灶均能准确定位。47例获随访,3年生存率为79.49%,5年生存率为71.9%。继发膀胱癌23.4%,肿瘤局部复发1例,未见局部复发或远处转移,肾功能正常51.1%。结论:IVP及B超检查对本病病灶定位及定性诊断率低,但应作为常规检查;上尿路逆行造影对本病病灶定位准确率高,可作为IVP检查患肾不显影者的常规检查方法;CT及MRI对本病诊断率高,并能判断肿瘤向外浸润程度及周围淋巴结情况,应作为进一步检查措施。患肾输尿管全切除术是治疗本病的首选方法,对浅表性肿瘤、独肾或对侧肾功能不全者可行输尿管部分切除术或经皮肾镜或输尿管镜治疗。Objective: To discuss the proper methods of the diagnosis and management of primary transitional cell carcinoma(TCC) of ureter. Methods: Retrospective analysis of 53 clinical cases in the period from January 1995 to December 2003. Result: Ratios of final diagnosis of primary ureteral transitional cell carcinoma (TCC) by intravenous pyelogram (IVP), ultrasonic examination(USE), CT(computed tomography) and MRI were 3/53, 19.1%, 82.1% and 74.1%, respectively. Retrograde pyelography could locate accurately for the carcinoma. Forty-seven cases were followed-up, the 3-year and the 5-year survival rate were 79.49% and 71.9% respectively. 23.4% of the cases were detected with bladder tumor during the follow-up period and 51.1% were normal. Conclusions: The right rate of diagnosis of IVP and B ultrasomotonography for this disease are very poor, but they should be considered as the routine examinations. Retrograde pyelography can improve it further, CT and MRI could know infiltration and lymphoid node. Radical resection of the kidney and the full ureter was the best method for this disease, Resection of a part of ureter or PCN (percutaneous nephroscopy) and ureteroscopy were especially for superficial tumor, unitesticle or renal dysfunction on other side.

关 键 词：输尿管癌 诊断 治疗 

分 类 号：R737.13[医药卫生—肿瘤]