原发性输尿管癌的诊断与治疗（附25例报告）

目的提高原发性输尿管癌的诊断与治疗水平。方法对1998年至2006年9月收治的25例原发性输尿管癌患者的诊断、治疗经验进行总结。结果25例术后病理检查均证实为输尿管癌。本病主要症状有肉眼血尿、腰痛、病侧肾积水。尿路造影、膀胱镜、输尿管镜检查为主要诊断手段。患侧肾输尿管全切及膀胱袖状切除是首选术式。结论凡原因不明的血尿患者,经B超或静脉肾盂造影检查,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分期密切相关,早期诊断,正确治疗和预防复发是提高患者生存率的关键。

The diagnosis and treatment of primary ureteral carcinoma(25 cases reports)

Objective To improve the diagnosis and treatment of the primary ureteral carcinoma.Methods Diagnosis and treatment of primary ureteral carcinoma in 25 cases from August 1998 to September 2006 were analyzed retrospectively.Results All 25 cases were pathologically diagnosised as ureteral carcinoma after surgery.The main symptom of the disease was hematuria,lumbodynia and hydronephrosis of the affected kidney.Urography,cystoscope and ureterendoscopy were the main diagnostic techniques.The optimal surgery was radical nephre-ureterectomy and partial bladder resection.Conclusions All patients with unknown hematuria and those with hydronephrosis disclosed by B-ultrasound or intravenous pyelogram examination should be excluded from primary ureteral carcinoma.The prognosis was closely associated with the pathologic grade and stage of the tumor.Early diagnosis,proper treatment as well as preventing tumor recurrence were crucial to improve the survival rate.