膀胱鳞状细胞癌和膀胱腺癌的临床病理特征及预后分析  

Analysis of clinicopathological characteristics and prognosis of bladder squamous cell carcinoma and adenocarcinoma

作　　者：任昊天 李宁阳 翟天元 司惠妍 姚文诚[1] 王军[1] 李松超[1] 贾占奎[1] 杨锦建[1] Ren Haotian;Li Ningyang;Zhai Tianyuan;Si Huiyan;Yao Wencheng;Wang Jun;Li Songchao;Jia Zhankui;Yang Jinjian(Department of Urology,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Breast Surgery,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院泌尿外科,450052 [2]郑州大学第一附属医院乳腺外科,450052

出　　处：《中华泌尿外科杂志》2021年第3期185-191,共7页Chinese Journal of Urology

摘　　要：目的探讨膀胱鳞状细胞癌(SqCC)和膀胱腺癌的临床病理特征及预后相关因素。方法回顾性分析郑州大学第一附属医院2011年10月至2019年1月收治的107例膀胱非尿路上皮癌(NUBC)患者的病例资料。男78例,女29例,男女比例为2.69∶1;中位年龄62.0(51.0,72.0)岁。根据组织学类型将患者分为SqCC组、脐尿管腺癌组和非脐尿管腺癌组。SqCC组55例,男40例,女15例;年龄69.0(58.0,75.0)岁;有吸烟史14例;就诊原因为血尿35例,膀胱刺激征13例,排尿困难2例,疼痛5例;肿瘤位于前后壁18例,侧壁27例,三角区8例,顶壁2例;肿瘤直径4.5(3.0,6.0)cm;肿瘤单发37例,多发18例;行根治性膀胱切除术38例,膀胱部分切除术4例,经尿道膀胱肿瘤切除术(TURBT)9例,介入手术2例,未手术2例。脐尿管腺癌组20例,男14例,女6例;年龄53.5(43.5,57.8)岁;有吸烟史6例;就诊原因为血尿16例,膀胱刺激征1例,疼痛2例,无症状1例;肿瘤位于前后壁4例,顶壁16例;肿瘤直径3.0(2.0,4.8)cm;肿瘤单发18例,多发2例;行膀胱部分切除术16例,根治性膀胱切除术1例,TURBT 1例,未手术2例。非脐尿管腺癌组32例,男24例,女8例;年龄55.0(46.3,70.8)岁;有吸烟史11例;就诊原因为血尿16例,膀胱刺激征3例,排尿困难1例,疼痛7例,无症状5例;肿瘤位于前后壁17例,侧壁7例,三角区5例,顶壁3例;肿瘤直径3.6(2.0,4.5)cm;肿瘤单发23例,多发9例;行根治性膀胱切除术11例,膀胱部分切除术9例,TURBT 9例,未手术3例。3组年龄、就诊原因、肿瘤直径、肿瘤部位、手术方式差异均有统计学意义(P<0.05)。比较3组的临床病理特征和预后差异,并应用Cox比例回归风险模型分析影响预后的危险因素。结果本研究107例中,91例获得随访,总体随访率85.1%。中位随访时间26(7,48)个月,3、5年总生存率分别为54.1%和42.2%。SqCC组术后接受化疗11例,放疗3例,膀胱灌注治疗12例;术后复发10例;淋巴结转移17例;远处转移19例;pT分期pT_(x)期5例,Objective To explore the clinicopathological characteristics and prognostic factors of bladder squamous cell carcinoma(SqCC)and bladder adenocarcinoma.Methods A retrospective analysis of the clinical data of 107 patients with nonurothelial carcinoma of the bladder admitted to the First Affiliated Hospital of Zhengzhou University from October 2011 to January 2019 was performed.Among the 107 patients,78 were males and 29 were females(ratio 2.69∶1),and the median age of onset was 62.0 years.According to histological types,patients were divided into SqCC group,urachal adenocarcinoma group and non-urachal adenocarcinoma group.There were 55 cases in the SqCC group,including 40 males and 15 females.Their mean age was 69.0(58.0,75.0)years.14 cases had the history of smoking.The clinic manifestation included hematuria in 35 cases,bladder irritation in 13 cases,dysuria in 2 cases and pain in 5 cases.Tumors located at the anterior and posterior walls in 18 cases,at the lateral wall in 27 cases,at the triangular area in 8 cases and at the apical wall in 2 cases.The average diameter of tumor was 4.5(3.0,6.0)cm.37 cases suffered with single tumor and 18 cases suffered with multiple tumors.The surgical method was radical cystectomy in 38 cases,partial cystectomy in 4 cases,TURBT in 9 cases,interventional surgery in 2 cases,and no operation in 2 cases.There were 20 cases in the urachal adenocarcinoma group,including 14 males and 6 females;age 53.5(43.5,57.8)years;6 cases with a history of smoking.The clinic manifestation included hematuria in 16 cases,bladder irritation in 1 case,pain in 2 cases and asymptomatic in 1 case.Tumors located at anterior and posterior walls in 4 cases and at apical wall in 16.The average diameter of tumor was 3.0(2.0,4.8)cm.Single tumor was present in 18 cases,multiple tumors were present in 2 cases.The surgical method was partial cystectomy in 16 cases,radical cystectomy in 1 case,TURBT in 1 case and no operation in 2 cases.There were 32 cases in the non-urachal adenocarcinoma group,including 24 ma

关 键 词：膀胱肿瘤 非尿路上皮癌 鳞状细胞癌 脐尿管腺癌 非脐尿管腺癌 预后 

分 类 号：R737.14[医药卫生—肿瘤]