膀胱原发性印戒细胞癌3例报道并文献复习

背景与目的：原发性膀胱印戒细胞癌（Signet—ring cell carcinoma，SRCC）临床极为罕见，国内外报道数甚少，对此病的临床规律缺乏深入了解。本研究旨在通过分析原发性膀胱SRCC患者的临床特征及治疗方式，探讨原发性膀胱印戒细胞癌的临床特点。方法：回顾性分析3例原发性膀胱SRCC患者的临床特征、治疗方案、随访预后等资料，并结合文献进行复习。结果：3例术前均行B超、CT、膀胱镜、活检等明确诊断为印戒细胞癌，并行相关检查排除转移性肿瘤。2例行腹腔镜下全膀胱切除加原位回肠新膀胱术，1例行腹腔镜下全膀胱切除加回肠膀胱术。1例术后行顺铂及5-Fu全身化疗1次，另2例未行化疗。1例随访至术后6个月死于全身多发转移，另2例随访至术后8、12个月无复发及转移。结论：原发性膀胱印戒细胞癌发病率低，无特征性临床表现和影像学特点，肿瘤呈浸润性生长，治疗主张在患者全身情况允许下应尽可能的行根治性膀胱全切术。

Primary signet ring cell carcinoma of the bladder (report of 3 cases and review of the literature)

Background and purpose: Primary signet ring cell carcinoma(SRCC) of the bladder is rarely diagnosed in the clinic. Few cases have been reported in the literature, so there was lack of understanding of the primary bladder SRCC in terms of diagnosis and treatment. Our study was to investigate the clinical features and treatment strategy for primary SRCC of the bladder and review the status of the disease along with the literature. Methods: 3 cases of primary bladder SRCC were studied, including clinical features, treatment, follow-up and their prognosis.The literature was reviewed. Results: All cases received ultrasound, computerized tomography, cystoscopy, biopsy and other related lab tests for diagnosis and differential diagnosis. Laparoscopic radical cystectomy and orthotopic ileal neobladders were performed in 2 cases, while the other case received laparoscopic radical cystectomy and ileal conduit diversion, Chemotherapy (cisplatin and 5-fluorouracil) was delivered in one case after surgery. One patient died at 6 months postoperatively because of multiple metastasis. The other 2 cases have been followed-up only for 8 and 12 months postoperatively, and no recurrence or metastasis have been observed. Conclusion: Primary SRCC of the bladder lacks distinctive clinical and imaging manifestations. The tumor grows very invasively. Radical cystcctomy is one of the optimal approaches for treatment of SRCC of bladder.