膀胱非上皮性肿瘤25例诊治报告  

Diagnosis and treatment of bladder non-epithelial tumors (report of 25 cases)

作　　者：刘兵[1] 刘屹立[1] 王平[1] 

机构地区：[1]中国医科大学附属第四医院泌尿外科,沈阳110032

出　　处：《中华泌尿外科杂志》2006年第5期345-348,共4页Chinese Journal of Urology

摘　　要：目的 总结膀胱非上皮性肿瘤的影像及临床诊断特点,探讨治疗方法与预后的关系.方法 回顾性分析25例膀胱非上皮肿瘤临床资料.男16例,女9例.年龄2～71岁.其中血尿6例,下腹部肿块2例,尿频14例,排尿困难2例,排尿晕厥1例.超声及CT检查发现22例膀胱占位病变,3例盆腔肿物及膀胱壁受累.均行膀胱镜检查,穿刺活检17例.结果 15例良性肿瘤行单纯肿瘤剜除术或膀胱部分切除术;10例恶性肿瘤行膀胱部分切除术或膀胱全切术.恶性肿瘤术后辅助化疗、放疗.随访3个月～11年.良性肿瘤均无复发,恶性肿瘤9例死于术后3年内,平均存活16个月;1例膀胱恶性淋巴瘤带瘤存活6年.结论 膀胱非上皮性肿瘤临床上少见,病理类型复杂,恶性居多,预后较差.膀胱部分切除术或膀胱全切术是本病的主要治疗方法,恶性肿瘤结合其病理特点辅助放化疗,疗效不理想,预后差别较大.Objective To summarize the characteristics of images and clinical diagnosis of bladder non-epithelial tumors, and to investigate the relationship between the therapeutic methods and prognosis of the disease. Methods The clinical data of 25 patients （16 males and 9 females,aged between 2 -71 years） with bladder non-epithelial tumors treated in our hospital were retrospectively analyzed. The clinical manifes＇s tutions included hematuria （ 6 patients）, lower abdominal lump （ 2 ）, frequent urination （ 14 ）, dysuria （ 2 ） and fainting during voiding （ 1 ）. Ultrasound and CT examinations suggested space-occupying lesions in the bladder in 22 patients and pelvic tumor involving the bladder wall in the other 3 patients. Cystoscopy was performed in all patients and 17 patients got biopsy. Results Simple tumor resection or partial cystectomy was carried out in 15 patients with benign tumors ;the rest 10 patients with malignant tumors underwent partial or radical cystectomy. Adjuvant radiotherapy and chemotherapy were performed in malignant tumor patients. Follow-up time was 3 months to 11years. No recurrence was found in benign tumor patients. Nine patients with malignant tumors died in 3 years after operation （ mean survival time of 16 months）. A patient with bladder malignant lymphoma survived for 6 years. Three recurrences occurred in another bladder leiomyosarcoma patient who had tumor resection. Conclusions Bladder non-epithelial tumors are relatively rare in clinical. The pathological types of the tumors are complicated, most of them are malignant and the prognosis is relatively poor. The clinical perception of these tumors is inadequate and misdiagnosis rate is high. Deep-site biopsy under cystoscope can improve the diagnostic rate. Partial or radical cystectomy is the main therapy for these tumors ,and adjuvant radiotherapy and chemotherapy can be used according to the pathological features, but the effects are uncertain and the prognosis is quite different.

关 键 词：膀胱肿瘤 非上皮性肿瘤 

分 类 号：R737.14[医药卫生—肿瘤] R734.2[医药卫生—临床医学]