膀胱鳞状细胞癌诊疗体会

目的：探讨膀胱鳞状细胞癌的病因、诊断与治疗。方法：回顾性分析8例膀胱鳞癌患者的临床资料,复习相关文献。结果：2例行膀胱部分切除术,6例行膀胱全切术,术后均行放疗或免疫疗法,行膀胱部分切除术者至今仍生存1例,为结合免疫治疗患者,1例死亡者由于恶性肿瘤转移。行膀胱全切术者6例,至今生存2例,3例死亡,此3例均由于恶性肿瘤多发转移,1例失访。结论：膀胱鳞癌的预后较差,大多数患者在被诊断时已属晚期,膀胱鳞癌的恶性程度较高,早期诊断和治疗非常重要,行膀胱全切术效果较确实,术后结合免疫疗法可延长生存时间。     

膀胱鳞状细胞癌15例报告

 膀胱鳞状细胞癌是较为少见的膀胱上皮肿瘤 ,我院 1978年 2月至 1997年 10月共收治膀胱恶性肿瘤 833例 ,其中经病理证实为膀胱鳞状细胞癌 15例 ,占 1 8%。报告如下。临床资料 :本组 15例 ,男 12例 ,女3例。年龄 34岁～ 76岁 ,平均 5 6 8岁。主要临床表现为肉眼全程血尿、终末血尿及镜下血尿 ;膀胱刺激症状及尿路感染 ;3例有膀胱结石史。 10例行尿脱落细胞检查 ,7例阳性。行静脉尿路造影13例 ,7例显示有单、双侧肾积水或肾功能不全 ,4例有膀胱充盈缺损。Ｂ超检查 9例 ,均提示膀胱内占位性病变。5例行ＣＴ扫描检查者 4例显示肿瘤已浸润至膀胱全层及前列腺组织 ,其中 1例有盆腔淋巴结转移。 15例均行膀胱镜检查 ,9例肿瘤无蒂 ,表面呈地毯样、结节状或桑椹状。粘膜肿胀呈大泡状 ,其表面有坏死组织并可见尿盐沉着。肿瘤发生部位有三角区、底后部、顶部、侧壁及颈部。肿瘤大小 2～ 6ｃｍ。 15例经病理检查均为膀胱鳞状细胞癌 ,其中低分化鳞状细胞癌 5例 ,角化型鳞状细胞癌 4例 ,溃疡型鳞状细胞癌 3例 ,移行细胞癌化生鳞状细胞癌 4例。本组病例按ＴＮＭ临床分期 :Ｔ2 3...     

膀胱鳞状细胞癌八例

目的　探讨膀胱鳞状细胞癌的发病、诊断、治疗及预后。方法　临床资料回顾性分析。结果　本病占同期膀胱肿瘤 3 4% ,均有膀胱刺激症和血尿 ,3例并有膀胱结石 ,4例伴有前列腺增生。按JEWTT分期 :B期 5例 ,C期 2例 ,D期 1例。本组病例均经病理确诊。结论　膀胱鳞癌治疗效果及预后均较差。     

膀胱鳞状细胞癌12例报告

膀胱鳞状细胞癌 (以下简称鳞癌 )较少见 ,我院 1988年 3月～ 2 0 0 2年 6月收治 12例 ,现报告如下。1　临床资料本组男性 10例 ,女性 2例 ;年龄 45～ 78岁 ,平均 62 .6岁 ;6例有吸烟史。主要症状为血尿 ,其中伴膀胱刺激症状者 8例 ,伴排尿中断者 2例。病程 2～ 9个月。实验室检     

膀胱结石并发膀胱鳞状细胞癌14例报告

膀胱鳞状细胞癌较少见,约占膀胱肿瘤病例的0.5%~2.0%,预后差[1]。我们自1982年1月至2006年1月收治760例膀胱结石患者,其中并发膀胱鳞癌者14例(1.8%),现将14例膀胱结石并发膀胱鳞癌的诊治体会报告如下。1临床资料本组14例,男性10例,女性4例。年龄27~68岁,平均34岁。病程3个月~28     

膀胱鳞状细胞癌八例

目的 探讨膀胱鳞状细胞癌的发病、诊断、治疗及预后。方法 临床资料回顾性分析。结果本病占同期膀胱肿瘤３．４％，均有膀胱刺激症和血尿，３例并有膀胱结石，４例伴有前列腺增生，按ＪＥＷＴＴ分期：Ｂ期５例。Ｃ期２例，Ｄ期１例。本组病例均经病理确诊。结论 膀胱鳞癌治疗效果及预后均较差。     

膀胱类癌诊疗体会

0引言膀胱类癌是一种原发于膀胱的神经内分泌肿瘤,为罕见病例,从1994年至今共收治4例,现结合文献对原发性膀胱类癌的临床病理学特征和诊疗特点进行探讨。     

腮腺原发性鳞状细胞癌

报道腮腺原发性鳞癌１４例，男性１１例，女性３例，年龄２０～６６岁（平均，５２岁）。Ⅰ期３例，Ⅱ期４例，Ⅲ期７例，均经病理证实，并排除转移性鳞癌和腮腺粘液表皮样癌可能。单纯手术或放疗各２例，手术＋放疗６例，动脉化疗＋放疗＋手术３例，１例仅行动脉化疗。３年、５年生存率分别为３８．５％，１８．２％。初步探讨其临床病理特点。     

空洞型肺鳞癌与非空洞型肺鳞癌的临床特征分析

Objective： To identify the differences between cavitating squamous cell lung carcinoma （cSLC） and non-cavitating squamous cell lung carcinoma （ncSLC）. Methods： Fifty-one patients with cSLC and 281 with ncSLC confirmed by surgery in our hospital between 1999 to 2000 were collected and their clinical, histological and survival features were retrospectively ana（yzed. Results： Patients with cSLC had more frequent manifestation of infection and weight loss. They usually experienced longer duration of pre-diagnosis and showed bigger tumor mass, larger primary tumor invasion with worse differentiated than ncSLC patients. There was no significant difference in age, sex, smoking history, family tumor history, personal tuberculosis history, disease location, TNM stage, lymph node invasion, and metastasis between the two groups. Median survival time was 29 months for cSLC and 35 months for ncSLC. One- and 3- year survival rates were 86.3% and 43.1% for cSLC vs. 91.1% and 47,0% for ncSLC respectively （P〉0.05）. Conclusion： Patients with cSLC presented with a bigger mass, a larger extent of primary tumor invasion, worse differentiated, more obstructed pneumonia that might result in longer duration of pre-diagnosis and more weight loss. As lack of differences in disease stages, lymph node invasion, metastasis and especially survival time with ncSLC, cSLC couldn＇t be classified as a special type of squamous cell carcinoma by present evidences.     

舌鳞状细胞癌的第二原发癌

目的评价口腔舌鳞状细胞癌中第二原发癌的发生及预后.方法回顾性分析1975～2000年329例口腔鳞状细胞癌患者的临床资料,生存患者的最短随诊时间为36个月.结果28例患者发生29个第二原发癌,其发生率为8.5%(28/329),其中包括2个同时第二原发癌(6.9%)、27个异时第二原发癌(93.1%).自舌癌确诊到异时第二原发癌确诊的平均时间为101(17～266)个月.23(79%)个第二原发癌发生于上气消化道,而食管是最常见的发生部位.发生于Ⅰ期病变9(11.8%)例、Ⅱ期病变10(10.8%)例、Ⅲ期病变9(6.7%)例,无一例发生于Ⅳ期病变,在临床分期之间,第二原发癌的发生率无明显区别.发生于T1病变11(13.4%)例、T2病变17(8.9%)例,无一例发生于T3和T4病变,在T1和T2病变间,第二原发癌的发生率无明显区别.在随诊期间,9例患者生存,19例患者死亡,其中死于第二原发癌14例.结论口腔舌鳞状细胞癌的第二原发癌并非不常见,食管为最常见的发生部位.第二原发癌易于发生在舌癌的早期病变,其预后较差.     

原发性甲状腺鳞癌7例临床分析

对7例原发性甲状腺鳞癌患者的临床资料进行回顾性分析，57.1%(4/7)患者死于局部复发，42.8%(3/7)死于远地转移，手术＋放疗3例无局部复发、且生存时间较长。作者认为手术＋放疗治疗甲状腺鳞癌有望减少局部复发。     

Pure squamous cell carcinoma of the breast

Pathological curiosities have always fascinated the surgical community, and management of breast cancer by the physician has, at times, revealed such rarities. A recent case of squamous cell carcinoma in a clear fluid breast cyst has prompted a review of our experience with this rare pathology, and allowed us to make the following statements: We propose that squamous cell carcinoma of the breast arises from ductal metaplasia. When the T.N.M. system is applied to the squamous cell lesion, the apparent poor prognosis that it is believed to carry may not be so apparent. If no other primaries are identified after extensive metastatic work-up, surgical therapy consisting of total mastectomy with complete axillary dissection, is very effective in local control of tumor progress. Nodal status will indicate the need for additional modalities of therapy.     

Multidisciplinary approach in the treatment of patients with small cell bladder carcinoma

Small cell carcinoma of the urinary bladder (SCCUB) is considered to be a tumor with a neuroendocrine phenotype characterised by aggressive behaviour and poor prognosis. Small cell carcinoma of the urinary bladder comprises 0.35 to 1% of all bladder cancers and is frequently observed in combination with other histological subtypes of carcinoma. Clinical presentation is characterized by advanced stage at diagnosis and rapidly progressive disease. In daily clinical practice there is no gold standard for the management of patients affected by this disease. Treatment of patients with limited disease combines neoadjuvant platinum-based chemotherapy followed by specific local treatment of the primary tumour. Cystectomy or radiotherapy should be proposed on an individual basis. In the metastatic setting, prognosis remains poor with a potential benefit from chemotherapy containing platinum compounds. Treatment of small cell carcinoma of the urinary bladder is based on evidence obtained from case reports and retrospective analyses. Due to low disease frequency there is a lack of randomized trials to provide guidance as to optimal therapy. Thus, systemic and local approaches are extrapolated from the literature available for the treatment of small cell carcinomas at other (non-urological) sites. We provide an overview of the currently available literature with it’s main focus on the treatment of either locally advanced or metastatic small cell carcinoma of the urinary bladder.     

宫颈鳞状细胞癌患者血清鳞状细胞癌抗原变化的临床意义

目的　研究子宫颈鳞状细胞癌患者血清中鳞状细胞癌抗原水平与病理分级、临床分期及对治疗反应之间的关系。方法　利用雅培公司提供的 IMX全自动快速粒子酶免疫分析系统 ,对 2 5例正常献血员和 83例经病理学诊断的宫颈鳞状细胞癌患者 ,进行了血清中鳞状细胞癌抗原血清检测并分析其与病理分级、临床分期之间关系。其中 80例患者放射治疗前后血清鳞状细胞癌抗原水平变化情况进行了自身比较。结果　中晚期宫颈鳞状细胞癌患者血清鳞状细胞癌抗原水平与病理分级、临床分期之间无相关性。放射治疗前后患者血清鳞状细胞癌抗原水平有明显变化。结论　对子宫颈鳞状细胞癌患者 ,在治疗前后检测血清鳞状细胞癌抗原水平 ,可以作为对放射治疗疗效判断的参考指标之一。     

62例阴茎鳞状细胞癌治疗的临床分析

目的:提高阴茎鳞状细胞癌的治疗水平,寻求鳞状细胞癌合理有效的治疗方法。方法:回顾分析62例病理活检证实阴茎鳞状细胞癌治疗的临床资料。结果:除8例拒绝手术治疗外,其余54例均行手术治疗。45例行阴茎部分切除术,9例行阴茎全切加会阴部尿道造口术治疗,腹股沟淋巴结活检术31例,腹股沟淋巴结病理阳性9例,总活检阳性率为29.0%,行腹股沟淋巴结清扫术。5例行阴茎部分切除者3年内复发,再行阴茎全切除并尿道会阴部造口术及髂腹股沟淋巴清扫术。高分化鳞癌43例,中分化鳞癌7例,低分化鳞癌4例;9例术前淋巴结活检有癌转移,腹股沟淋巴结清扫均有转移,盆腔淋巴结转移4例,淋巴结清扫发现转移2例。按照Jackson分期:I期29例;II期13例;III期8例;V期4例。本组62例患者中44例获定期随访2-7年,随访率70.9%。3年、5年生存率分别为90.9%、75%。非手术治疗5年生存率仅为50%。结论:外科手术治疗是目前治疗阴茎鳞状细胞癌的有效方法,淋巴结清扫根据临床分级具体处理,手术联合术后化、放疗是否可减少复发及提高生存率,还需进一步研究。     

膀胱移行细胞癌的遗传学研究现状

膀胱移行细胞癌的遗传学研究主要围绕肿瘤的形成、诊断、治疗以及预后判断等方面进行,发现膀胱移行细胞癌的形成至少存在2条遗传学通路。由于膀胱移行细胞癌的遗传学改变缺乏特异性,利用单一遗传学改变诊断膀胱移行细胞癌敏感性低,采用多个遗传学指标诊断膀胱移行细胞癌可提高其敏感性,已有基因组水平的试剂盒应用于临床诊断。研究还发现一些可能与预后判断相关的遗传学改变。基于遗传学的诊断、分子分型和个体化治疗是今后研究的方向。