肾脏保留手术治疗输尿管移行上皮细胞癌患者的临床疗效分析  

Research kidney-sparing surgery for ureteral transitional cell carcinoma and long term efficacy

作　　者：汪伊新[1] 辜福贤[2] 甘启详 许杰 WANG Yixin;GU Fuxian;GAN Qixiang;xu Jie(Department of Urinary Surgery,The Second People Hospital of Guangyuan,Guangyuan 628000,Sichuan,China;Department of Urinary Surgery,The Central Hospital of Guangyuan,Guangyuan 628000,Sichuan,China)

机构地区：[1]广元市第二人民医院泌尿外科,四川广元628000 [2]广元市中心医院泌尿外科,四川广元628000

出　　处：《西部医学》2018年第10期1517-1519,1523,共4页Medical Journal of West China

基　　金：四川省卫生计委科研课题(160911)

摘　　要：目的探讨肾脏保留手术治疗输尿管移行上皮细胞癌患者的近远期临床疗效,为临床研究提供参考依据。方法选取2003年1月～2009年12月期间来我院诊治的35例输尿管移行上皮细胞癌患者,回顾性分析行肾脏保留手术治疗的临床资料。观察分析35例患者行肾脏保留手术治疗的近远期临床疗效。结果 35例输尿管移行上皮细胞癌患者年龄<65岁者30例,≥65岁者15例,经钬激光切除术、以及影像学分析等临床分析方法证实,病理分级G1 8例,G2 15例,G2～G3 6例,G3 6例,临床分期Ta期2例,T1期9例,T2期17例,T3期7例。35例患者在年龄、病理分级以及临床分期组内比较差异有统计学意义(P<0.05);35例患者在术后6个月～2年内均进行随访,其中16例患者经膀胱镜复查发现膀胱癌,均行膀胱癌电切术后,14例存活,2例死于心血管疾病;4例患者发生同侧肾盂癌,均行肾盂癌根治术后均存活;5例患者经临床确认并发输尿管狭窄,经过定期更换D-J管,均存活;10例患者输尿管癌局部复发,经行输尿管癌根治术,8例患者存活,2例死于局部复发。术后6月～2年,生存率为88.57%;术后5年随访调查结果显示:存活22例,其中G1 8例,G2 14例,Ta2例,T18例,T212例,均为低分级、低分期患者。死亡13例,大部分为高分级和高分期患者。结论输尿管移行上皮细胞癌是临床上少见的肿瘤,对患者行肾脏保留手术,低分级、低分期的患者预后良好。由于肾脏保留手术具有复发的危险,需要密切观察。应采取相应的治疗手段,延长患者生存时间。Objective To investigate the clinical efficacy analysis of renal retention and long term surgical treatment of ureteral transitional cell carcinoma,and provide reference for clinical research.Methods The clinical data of 35 patients underwent surgical treatment of renal retention were retrospectively analyzed.Results The age of 35 ureteral transitional cell carcinoma patients was more than 65 years and 15 cases more than 65 years.The clinical analysis demonstrated that histological grade G1 had 8 cases,G2 had 15 cases,G2-G3 had 6 cases,G3 had 6 cases,Ta had 2 cases,T1 had 9 cases,T2 had 17 cases and T3 had 7 cases.Comparison of 35 patients,there was a significant difference（P〈0.05）in age,tumor grade and clinical stage group.35 patients after 6 months to 2 years of follow-up were carried out.16 patients after cystoscopy found bladder cancer.The bladder cancer underwent transurethral surgery.14 patients survived.The other two patients died of cardiovascular disease.4 cases of patients were with ipsilateral renal pelvis cancer,renal pelvis cancer.5 patients were with clinically confirmed ureteral stricture after regular replacement DJ tubes.10 patients with ureteral cancer local recurrence after radical prostatectomy ureter and 8 patients survived,2 patients died of local recurrence.-2 Years after June 31 cases of survival,the survival rate was 88.57%.After 5-year follow-up survey showed that 22 cases survived,including G1 8 cases,G2 14 cases,Ta2 example,T18 cases,T212 cases were low-grade,low-stage patients.13 deaths,mostly in patients with high-grade and high stage.Conclusion ureteral transitional cell carcinoma is clinically rare tumors of patients with kidney-sparing surgery,low-grade,low-stage patients with a good prognosis.However,the risk of having a recurrence of kidney-sparing surgery,the need for close observation,take the appropriate treatment,prolong survival time.

关 键 词：肾脏保留手术 输尿管移行上皮细胞癌 近远期疗效 

分 类 号：R737.13[医药卫生—肿瘤]