膀胱癌患者常规行IVU检查的临床意义评估  

The clinical menifestation of routine international vegetarian union test for patients with bladder cell carcinoma

作　　者：范治璐[1] 蒋思雄[1] 于洋[1] 田军 尚耀华[1] 李达林[1] 王元元[1] 管晓东[1] 

机构地区：[1]大连医科大学附属第二医院泌尿外科,116027 [2]大连市旅顺口区人民医院

出　　处：《现代泌尿生殖肿瘤杂志》2010年第6期325-327,共3页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的对膀胱癌(bladder cell carcinoma,BCC)患者是否应常规行IVU检查的临床意义进行评估。方法回顾分析我院1995年至2008年诊治的1053例BCC患者的临床资料,包括膀胱肿瘤的位置、临床分期、病理分级、上尿路影像学检查结果。结果 1053例BCC患者中有28例伴发上尿路肿瘤,发生率为2.66%。其中20例为肾盂癌,IVU检查发现肾盂内充盈缺损,CT检查发现病变。另输尿管癌8例,IVU检查发现患侧上尿路不显影7例,输尿管下段充盈缺损1例;前者有6例经输尿管镜检查发现,1例经CTU检查示左输尿管下段占位病变。合并上尿路肿瘤患者的膀胱肿瘤位置均局限在患者上尿路肿瘤同侧输尿管口附近及三角区。结论本组BCC患者伴发上尿路肿瘤的几率低。采用无创超声检查有阳性上尿路发现及肿瘤位于输尿管口周围及三角区时应进一步行上尿路影像学检查,无需所有BCC患者均行IVU检查。Objective To evaluate the clinical necessity of routinely IVU in patients with bladder cell carcinoma （BCC）. Methods Retrospective analysis were performed for 1 053 patients with BCC in our hospital from 1995 to 2008, including the bladder tumor location, clinical stage, histological grade, upper urinary tract imaging examination results. Results 28 patients were companied with upper urinary tract tumor in all 1 053 BCC patients, with the occurrence rate of 2.66%, and 20 of which were renal pelvis cancer with filling defect in IVU and abnormal change in CT; the other 8 patients were urinary tract cancer, and 7 of them didn＇t develop in the upper urinary tract in IVU, 1 of, them showed filling defect in the lower part of urinary tract. 6 patients of the former part were detected by ureteroscopy, 1 patient found abnormal change in the lower part of left urinary tract with CTU, the location of BCC in the patients accompanied by upper urinary tract tumor were constricted in the ureterostoma and the triangular of the same side. Conclusions This group of patients with BCC were associated with lower risk of upper urinary tract tumors. Patients who were found positive findings by non-invasive ultrasound examination or tumor located around ureteral orifice or triangular area should accept upper urinary tract imaging examination. It was not necessary that all BCC patients accept IVU.

关 键 词：膀胱肿瘤 上尿路肿瘤 静脉尿路造影术 

分 类 号：R737.14[医药卫生—肿瘤]