20~30岁膀胱肿瘤患者临床特征分析

目的 探讨20～30岁膀胱肿瘤患者的临床病理特征和治疗预后特点.方法 回顾性分析2009年1月至2014年3月收治的20～30岁膀胱肿瘤患者的临床资料,对患者的基本信息、临床表现、诊断特点、病理结果、治疗方式和预后情况进行总结分析.结果 本组患者共20例,占同期膀胱肿瘤的1.22％(20/1 645),平均年龄(25.8±3.1)岁,男13例,女7例.以肉眼血尿为主要临床表现者10例,因非血尿症状检查发现者6例,健康体检中发现4例.肿瘤多发2例,单发18例;总计24枚,位于侧壁15枚,后壁3枚,前壁1枚,三角区3枚,膀胱颈口部2枚.B超检查发现22枚肿瘤,2例血尿患者B超检查阴性;B超测量肿瘤最大径为0.4～2.7 cm,平均(1.1±0.7)cm.膀胱镜的肿瘤诊断率100％.病理诊断为副神经节瘤1例,尿路上皮肿瘤19例(其中平坦型病变2例,乳头状肿瘤17例).19例患者接受了经尿道膀胱肿瘤电切治疗,1例给予吉西他滨和顺铂新辅助化疗4个周期后行剖腹探查.16例获随访,随访时间3个月至5年,平均(28±16)个月,随访期间3例复发,l例进展为肌层浸润性癌.结论 20～30岁膀胱肿瘤患者总体具有单发、低级别、低分期的特点,但也有高恶性度肿瘤发生的可能,相当部分患者临床症状隐匿值得重视,治疗后长期随访十分必要.

Bladder neoplasms in patients aged between 20 and 30 years old: an analysis of clinical characteristics

Objective To evaluate the clinicopathological features and prognosis of patients with bladder neoplasm aged between 20 and 30 years old. Methods The clinical data of the patients with bladder tumors aged 20-30 years old, who were treated from Jan. 2009 to March 2014, were retrospectively analyzed. The general information, clinical manifestations, diagnostic essentials, pathological outcomes, treatment strategies and prognoses were analyzed. Results A total of 20 patients were included in this study, which accounted for 1.22%(20/1 645) of all the bladder neoplasm cases in our hospital during the same period. The mean age of the 20 patients was (25.8±3.1) years old, including 13 males and 7 females. Gross hematuria as the main clinical symptoms were found in 10 patients, 6 patients were detected accidently due to non-hematuria symptoms, and 4 patients were diagnosed during the health checkup. There were 2 multifocal and 18 solitary tumors, with the total number of tumors being 24, including 15 in the lateral bladder wall, 3 in the posterior wall, 1 in the anterior wall, 3 in the trigone and 2 in the bladder neck. Two tumors in patients with hematuria were missed by ultrasound. The maximum diameters of tumors measured by ultrasound ranged from 0.4 cm to 2.7 cm (mean 1.1±0.7] cm). The detection rate of cystoscopy for tumors was 100%. The pathological results found 1 paraganglioma and 19 urothelial neoplasms, including 2 urothelial flat lesions and 17 papillary urothelial neoplasms. Of the 20 patients, 19 received transurethral resection of bladder tumor, 1 underwent exploratory laparotomy after four-cycles of neoadjuvant chemotherapy with gemcitabine and cisplatin. Sixteen patients were followed-up for 3 months to 5 years (mean 28±16] months). Three patients had recurrence, with one progressed to muscle invasive carcinoma. Conclusion Bladder neoplasms in patients aged 20-30 years old are usually solitary, of low grade and low stage; meanwhile, there is a possibility of highly aggressive disease. It is noteworthy that a good few of patients are asymptomatic. The long-term follow-up is crucial for all these patients.