成人膀胱平滑肌肉瘤17例诊治分析  

Clinical diagnosis and treatment of 17 cases of adult leiomyosarcomas of the urinary bladder

作　　者：刘宇[1] 文春森 张龙[1] 贾占奎[1] LIU Yu;WEN Chunsen;ZHANG Long;JIA Zhankui(Department of Urology,The 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,河南郑州450052

出　　处：《现代泌尿外科杂志》2022年第6期499-502,共4页Journal of Modern Urology

摘　　要：目的探讨成人膀胱平滑肌肉瘤(LMS-UB)的临床特征及临床诊疗方案。方法回顾性分析2008年6月-2020年9月郑州大学第一附属医院收治并经病理确诊的17例成人LMS-UB患者的临床和随访资料。结果17例患者中,13例男性,4例女性,男女比为3.25∶1,平均年龄为53.59±24.41(19~78)岁。4例一经确诊即行膀胱部分切除术,其中3例为非肌层浸润,术后分别行膀胱灌注和或化疗;9例患者接受了膀胱根治性切除术;8例肌层浸润患者均接受化疗,其中4例(50%)在5年内进展并死亡。结论成人LMS-UB罕见、临床特征不典型、预后差,易发生肌层浸润和远处转移。膀胱部分切除术可作为有效的替代治疗方案。对于局部晚期的患者,新辅助治疗可以提高整体治疗疗效,联合手术治疗的综合治疗可能是现阶段最好的治疗方案。Objective To explore the clinical characteristics,diagnosis and treatment of adult leiomyosarcomas of the urinary bladder(LMS-UB).Methods The clinical and follow-up data of 17 pathologically confirmed adult LMS-UB patients treated in our hospital during June 2008 and Sep.2020 were retrospectively analyzed.Results Among the 17 patients,13 were male and 4 were female,with a male-to-female ratio of 3.25∶1,and the average age was 53.59±24.41(19-78)years.Partial cystectomy was performed in 4 patients as soon as the diagnosis was confirmed,3 of whom were non-muscle invasive and received bladder perfusion and/or chemotherapy.Altogether 9 patients underwent radical bladder resection,8 of whom were myometrial invasive and received chemotherapy,and 4(50%)progressed and died within 5 years.Conclusion Adult LMS-UB is a rare bladder malignant tumor with atypical clinical features and poor prognosis.The disease progresses quickly,and is prone to muscle invasion and distant metastasis.Partial cystectomy can be an effective treatment.For locally advanced patients,neoadjuvant therapy can improve the overall therapeutic effect,and comprehensive treatment combined with surgery is the best treatment plan at this stage.

关 键 词：成人 膀胱平滑肌肉瘤 膀胱部分切除术 膀胱根治性切除术 综合治疗 膀胱灌注 化疗 

分 类 号：R737.1[医药卫生—肿瘤]