输尿管癌临床特性及误漏诊断原因的探讨  

Exploration of the clinical feature of ureteral carcinoma and the reasons for the diagnostic error

作　　者：杨堃[1] 陆鸿海[1] 张家镇 江鱼[3] 

机构地区：[1]上海市杨浦区中心医院泌尿外科,上海200090 [2]上海市江东泌尿外科医院,上海2000129 [3]上海交通大学医学院附属仁济医院泌尿外科,上海200001

出　　处：《现代泌尿外科杂志》2008年第2期103-105,共3页Journal of Modern Urology

摘　　要：目的探讨输尿管癌的临床特性及误漏诊断的原因,进一步提高临床诊治的效果。方法回顾性分析1986年1月-2005年12月间23例输尿管癌患者的临床资料。结果23例输尿管癌均为移行细胞癌,其中Ⅰ级5例,Ⅱ级12例,Ⅲ级6例。根据组织病理分期,其中T1期4例,T2期12例,T3期4例,T4期3例。8例(34.8%)合并尿路其他器官(肾盂3例,膀胱5例)癌。误诊为其他疾病4例,漏诊输尿管癌1例,误漏诊断率为21.8%。输尿管肿瘤切除20例中,盆腔局部复发3例(15%),均为T3期;膀胱新生肿瘤7例(35%),其中3例为T1期,4例为T2期。平均随访65(3-204)月,平均癌肿特定存活率分别为T1期87月,T2期74.4月,T3期13月,T4期5.6月。结论输尿管癌具有多中心、术后新生膀胱肿瘤,以及其他较为少见症状的临床特性,应避免误诊漏诊。Objective To explore the clinical feature of ureteral cancer, and possible reasons for diagnostic error to improve the treatment efficacy. Methods The clinical data of 23 patients with ureteral carcinoma from Jan. 1986 to Dec. 2005 were analyzed retrospectively. Results Pathological results in all patients were transitional cell carcinoma, grade I in 5 patients, grade Ⅱ in 12, and grade Ⅲ in 6. According to pathological tumor staging, the carcinoma was T1 in 4 cases, T2 in 12, T2 in 4, and T4 in 3. 8 patients （34.8%） had other carcinoma of urinary organs （3 pelvis and 5 bladder carcinomas）, 5 of whom （21.8%） had been misdiagnosed. Of the 20 patients who had ureteral cancer resected, 3 had local pelvis recurrence, all in stage T3. 7 had new-born bladder cancer, 3 in stage T1 and 4 in stage T2. Mean follow-up period was 65 months （ranging from 3-204）. Mean cancer specific survival was 87 months for T1 stage, 74.4 for T2, 13 for T3, and 5.6 for T4. Conclusion The ureteral cancer has the characteristics of multicenter, postoperative newborn bladder cancer, and other rare clinical signs, which should be considered to avoid misdiagnosis.

关 键 词：输尿管癌 临床特性 误漏诊断 

分 类 号：R737.13[医药卫生—肿瘤] R693[医药卫生—临床医学]