膀胱副神经节瘤8例诊治分析  

Diagnosis and treatment of 8 cases of bladder paraganglioma

作　　者：王东升 胡伟 武鹏 王佳 严奉奇 于磊 武国军 WANG Dongsheng;HU Wei;WU Peng;WANG Jia;YAN Fengqi;YU Lei;WU Guojun(Xi'an Medical University,Xi'an,Shaanxi 710086,China;不详)

机构地区：[1]西安医学院,陕西西安710068 [2]空军军医大学西京医院泌尿外科,陕西西安710032 [3]空军军医大学唐都医院泌尿外科,陕西西安710038 [4]西安市人民医院泌尿外科,陕西西安710199

出　　处：《中国临床研究》2023年第4期601-604,共4页Chinese Journal of Clinical Research

基　　金：国家自然科学基金资助项目(82002686)。

摘　　要：目的探讨膀胱副神经节瘤的病变特点及诊治经验。方法回顾性分析空军军医大学西京医院2011年8月至2022年4月收治的8例膀胱副神经节瘤患者的临床资料。结果其中4例男性,4例女性,年龄31~73岁,平均55.1岁。高血压3例,其中1例排尿时血压升高。8例中表现为血尿者2例,尿频、尿急2例,头晕、心悸1例,无症状者3例。2例术前明确诊断,3例出现术中血压急剧升高。8例均行手术切除,其中4例行膀胱部分切除术,4例行经尿道膀胱肿瘤电切术。免疫组化:CD56、嗜铬颗粒蛋白(CgA)、突触素(Syn)均阳性。术后随访3个月至10年,均无复发及转移。结论膀胱副神经节瘤在临床上罕见发病,术前诊断困难,CT、膀胱镜可定位诊断,尿香草苦杏仁酸、儿茶酚胺可定性诊断,术后需要病理及免疫组化结果明确诊断。手术切除是首选治疗方式,术后应长期随访。Objective To explore the pathological characteristics and the clicical experience in diagnosis and treatment of bladder paraganglioma.Methods The clinical data of 8 patients with bladder paraganglioma admitted to Xijing Hospital of Air Force Military Medical University from August 2011 to April 2022 were analyzed retrospectively.Results There were 4 males and 4 females,with a mean age of 55.1 years ranging from 31 to 73 years.Out of 3 cases of bladder paraganglioma complicated with hypertension,1 case had elevated blood pressure during urination.Among 8 patients,there were 2 cases with hematuria,2 cases with frequent and urgent urination,1 case with dizziness and palpitation and 3 asymptomatic cases.All 8 patients received surgical treatment,including 4 cases treated with partial cystectomy and 4 cases treated with transurethral resection of bladder tumors.Two cases were confirmed before operation,and 3 cases had sharp increase of blood pressure during operation.Immunohistochemistry showed that CD56,chromogranin A(CgA)and synaptophysin(Syn)were positive in all patients.No recurrence or metastasis occurred in the patients who were followed up for 3 months to 10 years after operation.Conclusion Bladder paraganglioma is a rare disease and is difficult to diagnose before operation.CT and cystoscopy can improve the diagnosis based on localization.The urinary vanillyl-mandelic acid(VMA)and catecholamine levels can be measured for qualitative diagnosis.Definite diagnosis depends on pathological and immunohistochemical examination after operation.Surgical resection is the first choice of treatment,and long-term follow-up is required after operation.

关 键 词：膀胱肿瘤 副神经节瘤 高血压 膀胱镜 儿茶酚胺 香草苦杏仁酸 

分 类 号：R737.14[医药卫生—肿瘤]