伴有印戒细胞癌的膀胱原发性非脐尿管型腺癌11例临床及病理分析  

Clinicopathological analysis of 11 cases with bladder primary non-urachal adenocarcinoma accompanied with signet ring cell cancer

作　　者：孙屏[1] 吕慧[1] 肖燕[1] 吴靓骅 张熔熔[1] 

机构地区：[1]南京医科大学附属无锡第二医院病理科,江苏省无锡市214002

出　　处：《江苏医药》2017年第13期955-958,F0003,共5页Jiangsu Medical Journal

摘　　要：目的探讨伴有印戒细胞癌的膀胱原发性非脐尿管型腺癌的临床及病理特点。方法回顾性分析11例伴有印戒细胞癌的膀胱原发性非脐尿管型腺癌患者的临床资料。结果 11例中,临床表现为无痛性肉眼血尿10例,膀胱刺激症状4例,排尿困难1例。均经病理诊断为伴有印戒细胞癌的膀胱原发性非脐尿管型腺癌。TNM分期Ⅰ期2例,Ⅱ期6例,Ⅲ期1例,Ⅳ期2例。行根治性膀胱全切加尿流改道术4例,行膀胱部分切除术4例,行经尿道膀胱肿瘤切除术3例。2例术后实施化疗和放疗,其他行膀胱灌注治疗。4例患者有复发和转移。随访5个月~8年,2例术后1年内死亡,9例生存1年以上。结论伴有印戒细胞癌的膀胱原发性非脐尿管型腺癌少见,预后差。早期诊断、选择合适的手术方式及术后辅助放化疗有益于改善患者的预后。Objective To analyze the clinicopathological features of the bladder primary nonurachal adenocarcinoma accompanied with signet ring cell cancer.Methods The clinical data of 11 patients with the bladder primary non-urachal adenocarcinoma accompanied with signet ring cell cancer were retrospectively analyzed.Results Of 11 patients,10patients had painless gross hematuria,4patients were with irritation sign of bladder and 1patient appeared dysuria.All the cases were pathologically diagnosed as bladder primary non-urachal adenocarcinoma accompanied with signet ring cell cancer.Two cases were in TNM stage Ⅰ,6cases were in stage Ⅱ,1case was in stage Ⅲ and2 cases were in stageⅣ.Radical cystectomy combined with urinary diversion,partial cystectomy and transurethral resection of bladder tumor were performed in 4cases,4cases and 3cases,respectively.Two patients accepted chemotherapy and radiotherapy and others underwent bladder perfusion treatment after surgery.Four patients had tumour recurrence and metastasis.All the patients were followed up for 5months to 8years,of whom 9patients survived for more than a year and 2patients died within a year after surgery.Conclusion Bladder primary non-urachal adenocarcinoma accompanied with signet ring cell cancer is rare and has a poor prognosis.Early diagnosis,appropriate surgical resection and postoperative adjuvant radiation and chemotherapy are beneficial to improving the prognosis of patients.

关 键 词：膀胱肿瘤 印戒细胞癌 

分 类 号：R365[医药卫生—病理学]