易误诊或延迟诊断的肾盂癌临床特点分析——附三例报告  

Analysis of clinical characteristics of patients with misdiagnosis or delayed diagnosis of renal pelvic carcinoma: a report of three cases

作　　者：吴杰英[1] 郭月飞[2] 罗云[1] 方友强[1] 李茂胤 王华 狄金明[1] Wu Jieying;Guo Yuefei;Luo Yun;Fang Youqiang;Li Maoyin;Wang Hua;Di Jinming(Department of Urology,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院泌尿外科,广州510630 [2]中山大学附属第三医院放射科,广州510630

出　　处：《新医学》2018年第12期915-919,共5页Journal of New Medicine

基　　金：广东省自然科学基金项目(2018A030313261);广东省医学科研基金项目(A2018079)

摘　　要：血尿以及影像学上明确的肾盂占位性病变是肾盂癌的典型特征,但部分肾盂癌患者临床症状或影像学表现不典型,肾盂癌被误诊为肾癌或被延诊的情况时有报道。该文报道了3例在外院误诊或延迟诊断的肾盂癌患者,通过总结3例患者的临床症状、实验室检查、影像学检查及有创操作检查的结果,分析其临床特点,为肾盂癌的正确、及时诊断提供思路。该文提示,反复无痛性肉眼血尿是肾盂癌的典型症状,对反复血尿的中老年患者,应警惕肾盂癌的可能。笔者提倡在CT、MRI等影像学基础上,配合尿脱落细胞、尿荧光原位杂交技术等无创检查,选择性应用输尿管软镜检查,使肾盂癌患者有机会获得及时、准确的诊断。Hematuria and the occupying lesions of renal pelvis confirmed by imaging examination are the typical features of renal pelvic carcinoma.Nevertheless,certain renal pelvic carcinoma patients have been misdiagnosed with renal carcinoma or delayed diagnosis due to nonspecific clinical symptoms or imaging findings.In this paper,three patients of renal pelvic carcinoma who were misdiagnosed or delayed diagnosis in other local hospitals were reported.Clinical symptoms,laboratory examination,imaging examination and invasive procedure outcomes of these three cases were summarized to analyze the clinical characteristics and provide ideas for accurate and timely diagnosis of renal pelvic carcinoma.This article prompted that recurrent painless hematuria is a typical symptom of renal pelvic carcinoma.The possibility of renal pelvic carcinoma should be considered for the middle?aged and elderly patients with recurrent painless hematuria.Based on CT,MRI and other imaging techniques,urine cytology,urine FISH and alternative non?invasive examinations are recommended and flexible ureteroscopy can be performed as necessary to deliver timely and precise diagnosis of renal pelvic carcinoma.

关 键 词：肾盂癌 误诊 延迟诊断 尿脱落细胞 荧光原位杂交技术 输尿管软镜 

分 类 号：R737.11[医药卫生—肿瘤] R730.44[医药卫生—临床医学] R445.2