脐尿管癌的病理分析及临床研究(附5例报告)  

Pathological analysis and clinical study of urachal carcinoma (report of five cases)

作　　者：余昆[1] 刘美平[1] 刘兴华[2] 谢珍国[3] 杨杰斌[4] YU kun;LIU Meiping;LIU Xinghua;XIE Zhenguo;YANG Jiebin(Department of Urology,Chongqing Three Gorges Central Hospital & Affiliated Three Gorges Hospital of Chongqing Medical University,Chongqing 404000,China)

机构地区：[1]重庆三峡中心医院(重庆医科大学附属三峡医院)泌尿外科,404000 [2]重庆三峡中心医院(重庆医科大学附属三峡医院)CT-MRI影像诊断中心,404000 [3]重庆三峡中心医院(重庆医科大学附属三峡医院)中心实验室,404000 [4]重庆三峡中心医院(重庆医科大学附属三峡医院)病理科,404000

出　　处：《现代泌尿生殖肿瘤杂志》2019年第2期100-104,共5页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的探讨脐尿管癌的临床及病理特征、治疗方法和预后。方法回顾性分析我院2015年9月至2017年10月收治的5例脐尿管癌患者的临床资料,其中男4例、女1例,年龄35~84岁,平均(55.8±16.4)岁,行经尿道膀胱肿瘤电切术(TURBT)或膀胱镜下肿瘤活检确诊腺癌后再行扩大性膀胱部分切除术(EPC)4例,1例因高龄、全身基础疾病较多在诊断性TURBT确诊腺癌后即放弃治疗。所有患者的临床资料、随访结果及生存情况都纳入统计分析。结果所有手术均顺利完成,无围手术期严重并发症发生。按照Sheldon临床分期,5例患者均为Ⅲ期,其中Ⅲa3例、Ⅲb1例、Ⅲc1例。所有患者的术后病理报告均为腺癌,其中黏液腺癌2例,中分化腺癌2例,另1例未报告具体腺癌类型。2例患者接受以5-氟尿嘧啶联合顺铂为基础的化疗。所有患者均获得随访,随访时间8~32个月,平均(18.4±10.1)个月,平均生存时间为(16.4±9.8)个月,1例拒绝行EPC及化疗的患者于随访期内死亡,临床分期为SheldonⅢb期。结论脐尿管癌是一种少见但具有侵袭性的恶性肿瘤,通常诊断时已是晚期阶段,需要全身治疗。EPC为其主要的治疗方法,结合化疗的综合方案对改善预后有一定的积极作用,但是仍需要大规模的前瞻性临床研究以证实。Objective To observe the clinical presentation, pathological condition, treatment method and outcome of patients with urachal carcinoma. Methods A retrospective analysis of five cases of urachal carcinoma diagnosed between September 2015 and October 2017 was carried out. Among them, there were 4 males and 1 female, aged 35 to 84 years old, with an average age of (55.8±16.4) years old. Transurethral resection of bladder tumor (TURBT) or cystoscopic biopsy confirmed adenocarcinoma, then extended partial cystectomy (EPC) was performed in 4 cases.Another 1 case, didn’t receive the further treatment because of advanced age and more systemic basic diseases, after adenocarcinoma was diagnosed by TURBT. The clinical data, follow-up results, and survival of all patients were included in the statistical analysis. Results All the five cases of operations were successfully accomplished without serious complications. According to Sheldon’ clinical stage, all 5 patients were in stage Ⅲ, including 3 cases of Ⅲa, 1 case of Ⅲb, and 1 case of Ⅲc. The postoperative pathological reports of all patients were adenocarcinoma, including 2 cases of mucinous adenocarcinoma, 2 cases of moderately differentiated adenocarcinoma, and 1 case without specific reporting of adenocarcinoma type. Two patients accepted chemotherapy on the basis of 5 -fluorouracil combined cisplatin. All patients were followed up for 8 to 32 months, averaging (18.4±10.1) months. The average survival time was (16.4±9.8) months, and 1 patient whose clinical stage was in sheidon Ⅲb and refused to EPC and chemotherapy died during the follow-up period. Conclusions Urachal carcinoma is a rare, invasive malignancy, which is usually diagnosed at a later stage of systemic treatment. EPC is its main treatment method, and a comprehensive treatment combined with chemotherapy has a positive effect on improving prognosis, but it still needs large-scale prospective clinical studies to confirm.

关 键 词：脐尿管癌 腺癌 病理 治疗 

分 类 号：R737[医药卫生—肿瘤]