膀胱腺癌的诊治:附12例报告

目的:探讨膀胱腺癌的诊治方法。方法:回顾性分析1996—2005年诊治12例膀胱腺癌患者的临床资料。结果:12例患者中男性7例,女性5例;年龄38～78岁;11例因血尿、尿频等尿路症状就诊,1例因其他疾病就诊时发现。B超检查均提示膀胱内占位;膀胱镜检发现肿瘤直径1.0～8.5 cm。5例首次就诊即行根治性全膀胱切除术;5例行膀胱部分切除术,4例术后复发,其中2例行根治性全膀胱切除术,2例再次行扩大膀胱部份切除术;2例患者行经尿道膀胱肿瘤电切术,其中1例术后1个月原位复发,行CT检查证实为脐尿管癌,行扩大膀胱部份切除,脐尿管切除术;1例首次术后病理提示膀胱移行细胞癌,术后3次复发,第3次手术后病理提示膀胱印戒细胞癌。10例患者获得随访,随访2～8年。2年生存率60%(6/10),5年生存率33%(2/6)。首次行全膀胱切除患者2年生存率75%(3/4),5年生存率67%(2/3);首次行膀胱部份切除患者2年生存率50%(2/4),5年生存率33%(1/3);首次行经尿道膀胱肿瘤电切术患者2例,其中脐尿管癌1例术后随访4年存活,未复发;移行细胞癌多次复发转变为印戒细胞癌1例术后随访2年存活。结论:膀胱腺癌是一种高度恶性肿瘤,预后差,早期积极的综合治疗对延长患者生存时间有重要意义。

Adenocarcinoma of Urinary Bladder:a Report of 12 Cases

Objective:To discuss the clinical characteristics of adenocarcinoma in urinary bladder.Methods..Clinical data of 12 patients with adenocarcinoma in urinary bladder treated in our hospital from 1996 to 2005 were analyzed retrospectively.Re- salts:The age of these patients was from 38 to 78 years.Hemaurine was found in 11 patients.The diameter of tumor was from 1.0 cm to 8.5 cm.Radical cystectomy were performed in 5 cases and partial cystectomy were performed in 5 cases.Transure- thral resction were performed in 2 cases in which 1 cases was diagnosis as urachal adenocarcinoma,the others was diagnosed as transitional cell carcinoma at first time and recurred 3 times in follow 3 years.Signet-ring cell adenocarcinoma was found at last time.10 cases were followed from 1 to 8 years.The 2-year and 5-year survival rates was 60%(6/10)and 33%(2/6),respec- tively.The 2-year and 5-year survival rates was 75%(3/4)and 67%(2/3),respectively after radical cystectomy.Furthermore, the 2-year and 5-year survival rate was 50%(2/4)and 33%(1/3)respectively after partial cystectomy.Conclusion:Comprehen- sive therapy is important in treating adenocarcinoma of urinary bladder because of its high risk and poor prognosis.