脐尿管腺癌：附6例报告及文献复习

脐尿管腺癌是膀胱内少见的恶性肿瘤.国内外文献仅有少量报道.脐尿管腺癌与原发性膀胱腺癌均为来源于腺上皮的恶性肿瘤.所以在病理活检中往往将脐尿管腺癌诊断为膀胱腺癌.在复查我院近几年来收治的205例膀胱恶性肿瘤的病理切片中,有11例为腺癌.其中6例为脐尿管腺癌,3例为膀胱原发腺癌,2例为继发腺癌.本文结合有关资料复习,并对其发病特点进行讨论.     

膀胱腺癌的诊断与治疗(附24例报告)

目的：提高膀胱腺癌的诊断与治疗水平。方法：分析经手术病理证实的24例膀胱腺癌患者资料。原发性膀胱腺癌23例，原发性膀胱腺癌行根治性膀胱全切除术＋尿流改道术9例，行广泛性扩大膀胱部分切除术11例；经尿道膀胱肿瘤切除术2例；未予手术治疗2例。结果：膀胱腺癌占同期膀胱癌的1．6％。22例获得随访，时间为3个月～9年，2例患者失访。本组1年生存率为63．7％，2年生存率50．0％，5年生存率为26．3％。结论：原发性膀胱腺癌宜行根治性全膀胱切除术，对复发、转移性患者应采用综合治疗，以提高生存率。     

膀胱腺癌14例报告

膀胱腺癌甚为少见,可分为原发性与继发性两类,早期不易诊断,恶性度高,预后不良。我院予1966年4月～1991年11月,共收治膀胱上皮性肿瘤326例中发现原发性腺癌11例,继发于脐尿管腺癌浸润膀胱1例,直肠癌根治术后,结肠癌术后盆腔转移浸润膀胱各1例,均经病理证实,现分析报告如下。临床资料男性9例,女性5例。年龄30～75岁,平均年龄56.7岁。病程最短20天,最长3年,平均8个月。主要表现为尿频、尿急、尿痛,血尿11例,其中3例排粘液尿,单纯血尿3例,1例急性大出血行急症手术,2例排尿困难,腹前壁或耻骨上肿块各1     

膀胱腺癌的诊断与治疗(附25例报告)

目的提高膀胱腺癌的诊断及治疗水平.方法对1996年～2005年收治的25例膀胱腺癌患者临床资料进行回顾性分析,其中原发性膀胱腺癌20例,脐尿管腺癌5例.原发性膀胱腺癌患者行经尿道电切术7例,膀胱部分切除术6例,根治性全膀胱切除术7例.脐尿管腺癌患者行扩大性膀胱部分切除术3例,根治性全膀胱切除术2例.结果17例获得随访,1年生存率52.9%(9例),2年生存率41.2%(7例),5年生存率17.6%(3例).结论扩大性膀胱部分切除术是脐尿管腺癌的主要手术方式,原发性膀胱腺癌宜行根治性膀胱全切术,综合性治疗有助于复发、转移患者的总体疗效及预后进一步提高.     

膀胱腺癌二例报告

膀胱腺癌二例报告殷赤军刘英娜吕春苗·病例报告·膀胱腺癌少见，约占膀胱癌的１－２％。现报告罕见膀胱印戒细胞癌和膀胱粘液腺癌（来自脐尿管残留）各一例。例１、女性，５５岁，间断性尿频尿痛及血尿４个月，于１９９４年９月２３日入院。Ｂ超示膀胱壁占位性病变。手术...     

膀胱腺癌28例报告

 1978年2月至1997年10月收治膀胱腺癌28例,其中原发性膀胱腺癌23例,脐尿管腺癌5例。文中分析了本病临床表现、膀胱镜检查及膀胱造影等特点,结合文献讨论组织起源、早期诊断及治疗原则。治疗上主张广泛膀胱部分切除术或全膀胱切除术,联合放疗、化疗及免疫治疗,可望提高5年生存率。     

膀胱腺癌18例报告

目的 提高膀胱腺癌病人的生存质量和生存期。方法 通过扩大切除范围,膀胱部分切除者术后行盆腔区域化疗,膀胱全切者术后行全身化疗。结果 一年生存率90％,三年生存率67％,5年生存率40％。结论 由于膀胱腺癌的浸润性行为,治疗以手术为主,扩大切除范围,术后辅以化疗是治疗该病的良好方法。     

原发性脐尿管腺癌六例

原发性脐尿管腺癌六例李光辉侯建国钱松溪夏广彬马永江原发性脐尿管腺癌少见，约占膀胱上皮癌的０．３４％。我院收治６例，报告如下。临床资料本组男性２例，女性４例，年龄３１～７７岁，平均５２岁。发病时间４～７个月，平均５．４个月。肉眼血尿６例，膀胱刺激症状２...     

脐尿管腺癌（附11例报告）

脐尿管癌临床少见，预后不良，发病机理一般认为是脐尿管的移行上皮化生所致。临床表现主要是无痛性肉眼血尿，伴尿频尿急，尿中含有粘液及耻骨上肿块。通过ＣＴ、Ｂ超和膀胱镜等多项检查再根据脐尿管癌的诊断标准，１１例中有７例患者术前作出正确诊断。２例有盆腔淋巴结转移，其中１例合并腹腔广泛转移。治疗以手术为主，采用扩大的膀胱切除术，即包括膀胱顶部、腹横筋膜和部分腹膜连同肿瘤整块切除，病理报告均为脐尿管粘液性腺癌。术后生存３例，２例术后１年，１例术后６年。５年存活率为９％。     

SMALL CELL CARCINOMA OF THE URINARY BLADDER：THREE CASES REPORT

Objective: To study the clinical features of patients with primary small cell carcinoma (SCC) of the bladder and to improve the diagnosis and treatment. Methods:Clinical data of 3 cases with primary SCC of the bladder were discussed and the pathology, diagnosis, treatment and prognosis were reviewed. Results: 3 cases of primary SCC of the bladder were presented. Of them the diagnosis was confirmed by pathological examination after operation (2 cases) and biopsy (1 case). One case with stage T4M1 died after three months‘ chemotherapy. One case with stage T2M0 underwent partial cystectomy and was treated with chemotherapy and one year later died of miocardial infarction. Another case with stage T4M0 underwent radical cystectomy and postoperative irradiation therapy. The patient was alive and had no recurrence of symptoms during two years follow-up. Conclusion: Primary SCC of the urinary bladder is highly malignant. Radical cystectomy combined with radiotherapy appears to be the efficient treatment. Chemotherapy seems to be of no significant effect.     

膀胱腺癌

目的 提高膀胱腺癌的诊治效果。方法 １２例脐尿管腺癌中,７例行扩大性膀胱部分切除;１５例原发膀胱腺癌中,１１例行膀胱部分切除术。结果 膀胱腺癌总的５年生存率２５．９％．脐尿管腺癌中,７例行扩大性膀胱部分切除者,无一例局部复发,１２例中有４例生存５年。原发膀胱腺癌的治疗主要为膀胱部分切除术,生存５年者３例,局部复发４例,均在原肿瘤部位。     

膀胱副神经节瘤3例报告及文献复习

目的 :探讨膀胱副神经节瘤的临床病理特点和鉴别诊断。方法 :通过HE及免疫组化染色观察 3例膀胱副神经节瘤并复习文献。结果 :膀胱副神经节瘤好发于年轻女性 ,常表现血尿 ,头痛 ,心悸 ,多汗 ,排尿后血压一过性升高。镜下似肾上腺嗜铬细胞瘤。 2例免疫组化示CgA ,NSE ,S - 10 0蛋白阳性 ,CK阴性。结论 :膀胱副神经节瘤为潜在恶性肿瘤 ,以膀胱部分切除为主。诊断需结合临床 ,病理及免疫组化结果。有条件者应长期随访     

Functional paragangliomas of the urinary bladder:a report of 9 cases

Background and Objective: Functional paraganglioma of the urinary bladder (FPUB) is a rare tumor. Misdiagnosis of FPUB before operation can lead to serious intraoperative consequences. In this article, we reported our experience in preoperative diagnosis and surgical treatment of FPUB. Methods: Clinical data of nine patients with FPUB treated between June 1985 and January 2009 at Peking Union Medical College Hospital were analyzed. Results: All patients underwent urinary catecholamine (CA) detection, B-ultr...     

直肠癌全直肠系膜切除术临床应用(附27例报告)

目的研究直肠癌患者行全直肠系膜切除术(TME)的临床疗效。方法对27例行TME术式的直肠癌患者的临床资料进行分析。结果27例均获根治性切除，15例行吻合器吻合，术后发生吻合口瘘2例。术后辅助化疗及放疗，近期无局部复发病例。结论TME是降低直肠癌术后局部复发率，提高生活质量的有效措施。直肠癌根治性手术中采用TME手术方法是非常重要的。     

原发性肺腺癌诊断与治疗的探讨

我院１９８３年３月～１９９１年１２月对１１５例原发性肺腺癌患者进行了外科治疗，占同期肺癌手术例的２７．３％。其１、３、５年生存率分别为６７．０％、３５．４％、２１．８％，全组无手术死亡。作者分析讨论了其独特的临床特点与影响预后的因素。认为肺腺癌的发病率正在逐年增长，为了提高远期疗效，应重视早期确诊、尽早手术、Ｎ２淋巴结的彻底清除以及术后配合综合治疗。     

Conditional survival for non-metastatic muscle-invasive adenocarcinoma of the urinary bladder after radical cystectomy

PurposeTo test the effect of conditional survival on 36-months’ cancer-specific mortality (CSM)-free survival in non-metastatic muscle-invasive adenocarcinoma of the bladder (ACB).Materials and methodsWithin the Surveillance, Epidemiology, and End Results database (2000–2018), ACB patients treated with radical cystectomy (RC) were identified. Multivariable competing risks regression (CRR) analyses assessed the independent predictor status of organ-confined (OC, T₂N₀M₀) vs non-organ-confined stage (NOC, T_3-4N₀M₀ or T_anyN_1-3M₀) on CSM. Conditional 36-months’ CSM-free survival estimates were computed based on event-free intervals of 12, 24, 36, 48 and 60 months after RC, according to stage.ResultsOf 475 ACB patients, 132 (28%) harbored OC vs 343 (72%) harbored NOC stage. In multivariable CRR models, NOC vs OC stage independently predicted lower CSM (hazard ratio 3.55; 95% CI 2.66, 5.83; p < 0.001). Conversely, neither chemotherapy nor radiotherapy were independently associated with CSM. In OC stage, 36-months’ CSM-free survival rate was 84% at baseline. Provided event-free intervals of 12, 24, 36, 48 and 60 months, conditional 36-months’ CSM-free survival estimates were 84, 87, 87, 89 and 89%. In NOC stage, 36-months’ CSM-free survival rate was 47% at baseline. Provided event-free intervals of 12, 24, 36, 48 and 60 months, conditional 36-months’ CSM-free survival estimates were 51, 62, 69, 78 and 85%.ConclusionsConditional survival estimates provide better insight into survival of patients with longer event-free follow-up. In consequence, conditional survival estimates might be highly valuable for individual patient counselling.     

膀胱肉瘤样癌的诊断与治疗(附四例报告)

目的提高膀胱肉瘤样癌的诊治水平.方法分析4例膀胱肉瘤样癌患者的临床资料,4例患者中男3例,女1例,年龄62～81岁,均有肉眼血尿或伴膀胱刺激症.肿瘤主要由移行上皮癌细胞和恶性间叶细胞(梭形或多形性细胞)组成,之间可见移行过渡.CK(+)、EMA(+)、Vim(+).结果 3例行膀胱部分切除加化疗,1例行膀胱全切加化疗及放疗.2例于1年内死于肿瘤复发和转移,另2例至今分别无瘤存活13个月和20个月.结论膀胱肉瘤样癌是一种高度恶性、预后差的肿瘤.确诊需依赖病理和免疫组织化学等检查,早期诊断和采用膀胱部分切除或根治性切除,配合放疗和(或)化疗可提高疗效.