根治性膀胱癌标本中肿瘤侵犯前列腺及精囊的病理学研究  

Pathological Study on Tumor Invasion in Prostate and Seminal Vesicles of Radical Cystectomy Specimens

作　　者：张劲松[1] 谭顺成[1] 李炯明[1] 刘建和[1] 陈戬[1] 闫永吉[1] 姜永明[1] 王燕[2] 李涛[3] 

机构地区：[1]昆明医科大学第二附属医院泌尿外科三病区,云南昆明650101 [2]昆明医科大学第二附属医院病理科,云南昆明650101 [3]解放军昆明总医院病理科,云南昆明650032

出　　处：《昆明医科大学学报》2014年第9期28-31,共4页Journal of Kunming Medical University

基　　金：云南省教育厅科学研究基金资助项目(2012Z152C)

摘　　要：目的对肌层浸润性膀胱癌侵犯前列腺危险因素进行研究,为保留前列腺包膜及精囊的根治性膀胱癌手术的开展寻找临床依据.方法对86例根治术后的膀胱标本进行系统病理切片检查,前列腺每间隔1 cm做多个冠状切面至前列腺尖部,明确肌层浸润性膀胱癌发生前列腺侵犯的情况,以及膀胱肿瘤的大小、部位、多发与单发、病理分级、临床分期等相关因素与前列腺、精囊侵犯之间的关系.结果 86例浸润性膀胱移行细胞癌根治术标本中,2例(2.33%)肿瘤侵犯至前列腺,其中1例为膀胱颈,另1例为三角区的多发肿瘤.临床分期为T2b、T3a各1例.所有病例中未发现前列腺尖部尿道、前列腺包膜及精囊受侵犯.T2a及位于膀胱侧壁的肿瘤未侵犯前列腺.结论低分期的肿瘤、位于侧壁的肿瘤则未发现有前列腺的侵犯.因此,可以将位于膀胱侧壁的低分期肌层浸润性移行细胞癌作为保留前列腺包膜及精囊的手术适应证.Objective The aim of this study was to investigate the clinical evidence of prostatic capsule- and seminal-sparing cystectomy by researching the risk factors of muscle invasive bladder transitional cell carcinoma invasion into the prostate. Methods Eighty-six patients with muscle invasive bladder transitional cell carcinoma were underwent radical cystectomy. The radical cystectomy specimens were performed pathological examination,many coronal plane sections were done to prostate apex every 1 cm interval. Identified whether the muscle invasive bladder transitional cell carcinoma encroached into the prostate or not and whether the diameter of tumor,position of tumor, solitary or multiple, grade malignancy and clinical staging have the correlativity with the prostate or seminal vesicles encroaching or not. Results Of the 86 muscle invasive bladder transitional cell carcinoma cases,two cases（2.33%） were encroached into the prostate,two cases were all multiple bladder transitional cell carcinoma,one was located in the bladder triangle,and another was located in the bladder neck. The clinical staging of these two cases were T2 b and T3 a one each. No encroachment of prostatic capsule, urethra of apex of prostate and seminal vesicles was found in all specimens. The prostate was not encroached in the specimens of T2 a or located in the bladder wall except the bladder triangle and the bladder neck. Conclusion The prostate was not encroached in the specimens of lower clinical staging or located in the bladder wall except the bladder triangle and the bladder neck.Therefore, one of the operative indication of the prostatic capsule and seminal vesicle-sparing cystectomy was the lower clinical staging tumor,which was located in the bladder wall except the bladder triangle and the bladder neck.

关 键 词：膀胱癌 肌层浸润 根治性膀胱切除 前列腺癌 

分 类 号：R737.13[医药卫生—肿瘤]