脐尿管腺癌六例临床分析  

Urachal adenocarcinoma of bladder： clinical analysis of six cases

作　　者：宋波[1] 李鑫[1] 贤少忠[1] 吴沛珊[1] 孔广起[1] 

机构地区：[1]首都医科大学附属北京潞河医院泌尿外科,101149

出　　处：《中华全科医师杂志》2017年第5期385-388,共4页Chinese Journal of General Practitioners

摘　　要：回顾性分析我院1996-2016年收治的6例膀胱脐尿管腺癌患者的临床资料和病理特点.6例中男性5例、女性1例,年龄31～65岁;占同期收治的906例膀胱癌的0.66%、16例膀胱腺癌的6/16;无痛肉眼血尿为最常见临床症状,其中1例发现时已出现盆腔淋巴结多发转移,行活检提示脐尿管腺癌,放弃治疗半年后死亡;2例术前诊断为脐尿管腺癌,行开放肿物切除术＋膀胱部分切除术,术后随访1年无复发,后失访;1例术前诊为膀胱尿路上皮癌,行开放膀胱部分切除术,术后病理诊断为脐尿管腺癌,术后行放疗＋氟尿嘧啶化疗,1年后肿瘤复发,行开放膀胱全切术＋脐尿管并脐切除术,随访至2016年9月（术后5年2个月）肿瘤无复发;2例术前诊断为脐尿管腺癌,行腹腔镜下扩大膀胱部分切除＋脐尿管并脐切除术,分别随访6年、1年3个月肿瘤无复发.病理及免疫组化是脐尿管腺癌诊断的金标准,脐尿管腺癌对放疗及化疗均不敏感,对于早期患者扩大膀胱部分切除术是首选治疗方法,脐尿管腺癌预后很差.The clinical and pathological data of 6 patients with urahcal adenocar,cinoma of the bladder admitted in Beijing Luhe Hospital from 1996 to 2016 were analyzed and relevant literature was reviewed.Urachal carcinoma accounted for 0.66% of the bladder cancers admitted at the same period （6/906） and 6/16 of the bladder adenocarcinomas.Painless hematuria was the most common symptom.One patient had extensive metastasis as shown in biopsy and died 6 month after the diagnosis.Two patients underwent partial excision of bladder with no tumor recurrence.One patient underwent partial cystectomy followed by chemotherapy and radiotherapy, recurrence occurred one year later and he then received radical cystectomy.Another 2 patients underwent laparoscopic cystectomy and en bloc resection of umbilical ligament and umbilicus, and no recurrence was found in the follow-up for 6 years and 15 months, respectively.Pathological and immunohistochemistry are essential for the diagnosis of urachal adenocarcinoma.As it is not sensitive to radiotherapy or chemotherapy,surgery is the preferred treatment for patients with early stage diseases.Individual anticancer therapy may be the trend of treatment.

关 键 词：膀胱肿瘤 腺癌 腺癌 脐尿管 

分 类 号：R737.14[医药卫生—肿瘤]