膀胱腺癌12例临床诊断与治疗

目的探讨膀胱腺癌的诊断和治疗情况。方法回顾性分析我院1996—2008年收治的12例膀胱腺癌患者的诊治资料，并复习相关文献。结果6例患者接受根治性膀胱全切除术加尿流改道，4例行膀胱部分切除术，2例行TURBT术。接受保留膀胱手术的患者术后7～18个月均复发，其中4例再次手术行根治性膀胱全切除术加尿流改道，术后随访1例根治性膀胱全切除术患者和1例行膀胱部分切除术患者因发生远处转移而死亡，其余2例未见肿瘤复发。6例接受根治性膀胱全切除术加尿流改道患者中2例死于远处转移，其余4例随访至今未见肿瘤复发。结论膀胱腺癌恶性程度高，转移早，治疗过程中应采取积极的态度，尽早行根治性膀胱全切除术，并术后辅助放化疗，有利于减少肿瘤复发，提高患者生存时间。

Diagnosis and treatment of adenocarcinoma of urinary bladder

Objective To disscuss the clinical characteristics of adenocarcinoma in urinary bladder. Methods Analyzed the clinical data of 12 cases of patients with adenocarcinoma and reviewed the relative literature. Results Of the 12 patients,6 were underwent radical cystectomy and urinary diversion,4 underwent partial cystectomy and 2 underwent TURBT. Six patients who were not treated by radical cysectomy had recurred in seven months to eighteen months postoperatively, four patients of them were treated by the radical cystectomy and urinary diversion for the second time. At last two patients died of metastasis, two of six patients who underwent radical cysteetomy died of metastasis, and the other four patients were tumor free to now by following-up. Conclusion There is a higher malignant and earlier metastasis than BTCC for bladder adenocarcinoma, so only radical cystectomy aided for radiotherapy and chemotherapy can improve the survival time for patients.