青年人群膀胱尿路上皮癌病例分析  

Bladder urothelial carcinoma in patients less than 40 years old: 41-case series

作　　者：毕新刚[1] 李长岭[1] 马建辉[1] 王栋[1] 田军[1] 关有彦[1] 管考鹏[1] 

机构地区：[1]中国医学科学院肿瘤医院泌尿外科,北京100021

出　　处：《中国现代医学杂志》2013年第18期88-90,共3页China Journal of Modern Medicine

摘　　要：目的研究40岁以下膀胱尿路上皮癌患者临床表现、病理特点、治疗与预后等情况。方法回顾性分析2002年1月~2011年12月中国医学科学院肿瘤医院收治的41例40岁以下膀胱尿路上皮癌患者的临床资料,总结青年人膀胱尿路上皮癌的临床特点。结果本组患者占同期膀胱尿路上皮癌患者总数的2.2%。41例患者中男性29例,女性12例。平均年龄35岁（17~40岁）。初诊时以肉眼血尿为主要症状者26例（63.4%）,因尿痛发现者2例（4.9%）,无症状而由于体检发现者13例（31.7%）。肿瘤平均大小1.9 cm。肿瘤单发者33例（80.5%）,多发者8例（19.5%）。所有患者均采取TUR-BT术治疗。术后WHO病理分级：低级别尿路上皮癌38例（92.7%）,高级别尿路上皮癌2例（4.9%）,原位癌1例（2.4%）。术后TNM病理分期：pTis 1例（2.4%）,pTa 15例（36.6%）,pT1 25例（61.0%）。术后随访时间6~130个月,中位随访时间46个月。共有4例复发（9.8%）,平均复发时间为12月（6~18月）。随访过程中尚无死亡病例。结论青年膀胱尿路上皮癌患者肿瘤多数为单发,以低分级非浸润性肿瘤为主,恶性程度低,绝大多数可以通过TUR-BT治愈,术后复发率低。随着年龄的增长,肿瘤的病理分级、分期和复发率均显著增加,其机制可能与基因层次上不同的致病基因突变有关。To evaluate the clinical and pathological features,treatment and prognosis in bladder urothelial carcinoma in patients under 40 years old.【Methods】A retrospective review of bladder urothelial carcinoma in patients under 40 years old who had been treated from January 2002 to December 2011 were conducted.【Results】The incidence of bladder urothelial carcinoma in patients under 40 years was 2.2%.The male/female ratio was 2.4：1.0.The mean and median age was 35.At initial visit,63.4% of the patients presented with gross hematuria.Solitary tumor occurred in 33 cases and multiple carcinomas in 8 cases.According to WHO 2004 pathological grading of bladder urothelial carcinoma,38 cases were low-grade,2 cases were high-grade,and one case was CIS.As the T staging,one case was pTis,15 cases were pTa,and 25 case were pT1.The follow-up was 6～130 months.The overall recurrence rate was 9.8%.【Conclusions】In bladder urothelial carcinoma patients under 40 years,pathological grading and recurrence rate increase with age.Multiple tumors,tumor grade and stage are high risk factors for tumor recurrence.TUR-BT is the main surgical method for treating bladder cancer patients under 40 years.

关 键 词：膀胱 尿路上皮癌 青年人 复发 

分 类 号：R737.14[医药卫生—肿瘤]