泌尿男生殖系多原发癌的诊治  

Diagnosis and treatment of synchronous multiple primary malignant neoplasms of male genitourinaryurinary system

作　　者：邹伟[1,2] 江波涛[1,2] 李刚[3] 郭宗华[1,2] 杨君[1,2] 孔东波[1,2] 

机构地区：[1]咸宁市中心医院泌尿外科 [2]湖北科技学院附属第一医院,湖北咸宁437100 [3]天津医科大学第二医院泌尿外科

出　　处：《临床泌尿外科杂志》2012年第11期845-847,850,共4页Journal of Clinical Urology

摘　　要：目的:提高对同时发生的泌尿男生殖系多原发癌(MPMN)的诊断与治疗水平。方法:回顾性分析20例MPMN患者资料。20例均行手术治疗,其中4例晚期前列腺癌合并浅表性膀胱癌行TURBT+TURP,8例浸润性膀胱癌合并早期前列腺癌行根治性膀胱前列腺全切,4例浸润性膀胱癌合并局部晚期前列腺癌,行膀胱部分切除术+化疗及内分泌治疗。2例肾癌合并晚期前列腺癌均行根治性肾切除+内分泌治疗。1例肾癌伴膀胱癌行肾癌根治+TURBT。1例肾癌合并浸润性膀胱癌行肾癌根治+根治性膀胱全切。结果:病理诊断移行细胞癌18例,前列腺癌18例,肾透明细胞癌3例,乳头状肾癌1例。平均随访36(10～48)个月,12例平均生存23个月,8例无瘤生存。结论:泌尿男生殖系同时性MPMN易漏诊,早发现并采用手术为主的综合治疗可显著提高患者生存期,多瘤共存非预后不良的标志。Objective：To improve the diagnosis and treatment of multiple primary malignant neoplasms in uri- nary system. Method：A clinical and pathological data from 20 cases were retrospectively analyzed. All cases un- dergone operation. Transurethral resection of bladder tumor and TURP were performed for 4 cases of advanced prostate cancer associated with superficial bladder cancer. 8 patients with invasive bladder cancer and localized prostate cancer underwent radical eystoprostatectomy. 4 cases of invasive bladder cancer and locally advanced pros- tate cancer underwent partial cystectomy combined chemotherapy and hormonal therapy. 2 cases of kidney cancer with advanced prostate cancer were performed radical nephrectomy and hormonal therapy. One case with superfi- cial bladder cancer and kidney cancer treated with radical nephrectomy and TURBT. One case with synchronal kid- ney cancer and invasive bladder cancer underwent radical nephrectomy and radical cystectomy. Result： Eighteen pa- tients were pathologically diagnosed with bladder urothelial carcinoma and prostatic adenocarcinoma respectively. 3 cases were renal clear cell cancer and papillary kidney cancer for one. Only 12 cases of bladder cancer with syn- chronal prostate cancer were follow-up for 10-48 months, remain survival 23 months after operation. Another 8 cases have been followed up for 10-48 months and remain tumor free survival. Conclusion：Synchronal cancer of uri- nary tract was omitted often and the imaging and tumor markers screening should be strengthen Early detection and the surgical treatment can significantly improve survival, coexistence of multiple urinary cancer were not the signs of poor prognosis

关 键 词：泌尿系统 多原发癌 诊断 治疗 

分 类 号：R737[医药卫生—肿瘤]