局部晚期结肠癌膀胱浸润的研究进展  

Research progress on locally advanced colon cancer with bladder invasion

作　　者：蓝冰 王怀明[1,2] 王辉 马波[4] Bing Lan;Huaiming Wang;Hui Wang;Bo Ma(Department of General Surgery(Colorectal Surgery),The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China;Biomedical Innovation Center,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China;Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China;Department of General Surgery(Urology),The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China)

机构地区：[1]中山大学附属第六医院普通外科(结直肠外科三区),广州510655 [2]广州市黄埔区中六生物医学创新研究院,510655 [3]广东省结直肠盆底疾病研究重点实验室,广州510655 [4]中山大学附属第六医院普通外科(泌尿外科),广州510655

出　　处：《中华结直肠疾病电子杂志》2023年第6期505-511,共7页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：国家自然科学基金项目(No.82103084);广东省援疆农村科技(特派员)项目(No.KTPYJ2022030);中山大学临床研究5010计划(No.2017008,No.2019021)。

摘　　要：在局部晚期结肠癌患者中,肿瘤浸润膀胱的患者预后较差,随着技术的进步和治疗观念的更新,局部晚期结肠癌的诊断和治疗方法推陈出新。在诊断方面,现已开展的诊断手段有尿红细胞检测、盆腔或腔内B超、膀胱镜、盆腔CT或MRI增强扫描、术中或术后病理诊断等,其中肉眼血尿、膀胱镜检查、CT检查是发现膀胱浸润较为良好的诊断方法。在治疗方面,手术为局部进展期结肠癌的主要治疗方式,术前新辅助治疗是目前的治疗热点。在外科手术中,临床医生综合术前评估等因素,在膀胱部分切除术和全膀胱切除术之间进行选择。目前大多数学者认为,R0切除和预防局部膀胱内复发是结肠癌浸润膀胱患者手术方式选择的关键考虑因素。在围手术期药物治疗方面,新辅助治疗和辅助治疗也有较多研究进展,药物治疗的关键环节在于适宜人群的筛选。本篇综述期望能为临床医生在局部晚期结肠癌患者的诊治环节提供参照依据。Among the patients with locally advanced colon cancer,the patients with tumor infiltrating the bladder have a poor prognosis.With the progress of technology and the update of treatment concepts,the diagnosis and treatment methods of locally advanced colon cancer are introduced.In terms of diagnosis,the diagnostic methods currently carried out include urine red blood cell test,pelvic or intracavitary B-ultrasound,cystoscopy,pelvic CT or MRI enhanced scan,intraoperative or postoperative pathological diagnosis,etc.Among them,gross hematuria,cystoscopy,and CT examination are better diagnostic methods for finding bladder infiltration.In terms of treatment,surgery is the main treatment for locally advanced colon cancer,and preoperative neoadjuvant therapy is the current treatment focus.In surgery,clinicians should choose between partial cystectomy and total cystectomy based on preoperative evaluation and other factors.At present,most scholars believe that R0 resection and prevention of local intravesical recurrence are the key factors to consider in the selection of surgical methods for patients with colon cancer infiltrating bladder.In terms of perioperative drug therapy,there are also many research advances in neoadjuvant therapy and adjuvant therapy,and the key link of drug therapy is the screening of suitable population.This review is expected to provide reference for clinicians in the diagnosis and treatment of patients with locally advanced colon cancer.

关 键 词：结肠肿瘤 膀胱侵犯 术前诊断 围手术期治疗 研究进展 

分 类 号：R735.34[医药卫生—肿瘤]