51例原发性输尿管癌诊治报告

目的提高原发性输尿管癌的诊治水平。方法回顾性分析我院2000年1月～2008年10月收治的51例原发性输尿管癌临床资料,总结诊治经验。结果肉眼血尿和腰痛是主要的临床症状。B超、静脉肾盂造影、逆行尿路造影、输尿管镜检查和CT的确诊率分别为21.6%、8.7%、90.9%、76.9%、88.6%。所有患者均为移行细胞癌,术后发生膀胱肿瘤11例,高期别患者术后生存期不足1年,接受保守性手术的低期别患者术后3年生存率为86.7%（26/30）。结论高期别原发性输尿管癌预后不佳,低期别肿瘤可行保守性手术,改善预后的关键在于早期诊断和治疗。

Diagnosis and therapy of 51 cases of primary ureteral carcinoma

Objective To improve the diagnosis and therapy of primary ureteral carcinoma.Methods 51 cases of primary ureteral carcinoma between January 2000 and October 2008 in our hospital were retrospectively studied.Results Grass hematuria and unilateral flank pain are classical symptoms.The confirmed diagnosis ratio of B-ultrasound,intravenous pyelogram,retrograde urogram,ureteroscopy and CT are 21.6%、8.7%、90.9%、76.9%、88.6%.All cases were proved to be transitional cell carcinoma.Bladder tumor occurred in 11cases and high stage cases survived less than one year after operation.The 3 year survival rate of low stage cases who received conservative operation was 86.7%（26/30）.Conclusion The prognosis of high stage primary ureteral carcinoma is not optimistic.Conservative operation can be performed in low stage cases.Early diagnosis and treatment are the key to raise the prognosis.