原发性输尿管癌26例的诊断与治疗

目的：提高原发性输尿管的诊治水平。方法：结合献回顾分析了1986/2001收治的26例原发性输尿管癌的临床特点、诊断、治疗及预后。结果：25例术后病理检查证实为输尿管移行细胞癌，主要症状有肉眼血尿，病变侧肾积水。CT及膀胱镜检查，逆行输尿管造影和输尿管镜检查为主要诊断方法，以手术治疗为主。26例中有19例得以随访，其中13例生存，9例死亡。结论：凡原因不明的血尿患，经B超或静脉尿路造影检查，发现肾积水或肾不显影时，应考虑到原发性输尿管癌的可能，其预后与肿瘤的分级及分期密切相关。早期诊断、正确治疗和预防复发是提高患生存率的关键。

Diagnosis and treatment of primary ureteral carcinoma:Report of 26 cases

AIM To improve the diagnosis and treatment of primary ureteral carcinoma.METHODS The clinical characteristic,treatment and prognosis of primary ureteral carcinoma were retrospectively analysed with review of literature in 26 patients from 1986 to 2001. RESULTS The diagnosis of 25 cases was proved by pathological examination after operation. The main symptom was painless gross hematuria. The diagnostic methods were cystoscopy,retrograde ureteropyelography ,CT and ureteroscopy.Operation was the choice of treatment. 19 in 26 cases were followed - up, and among them 13 patients were survival with no tumor, and the others died. CONCLUSIONS All cases with hematuria of uncertain hydronephrosismor pyelic ioiaging in the ultrasonography or intravenous pyelogram should be considered as having primary ureteralcarcinoma. The prognosis of primary ureteral carcinoma is relevant to the grade and stage of tumor. Early diagnosis, reasonable treatment and prevention of recurrence can improve survival.