输尿管软镜在上尿路上皮肿瘤诊断中的应用价值

目的：探讨输尿管软镜住上球路上皮肿瘤诊断中的应用价值。方法：收集2006年6月～2012年4月间应用输尿管软镜镜检诊断上尿路上皮肿瘤57例资料。患者术前均行影像学检查（IVP＋泌尿系CT或CTU）。根据影像学俭杏有无肄常，结果分为A、B两组。所仃患者均使用F8输尿管镜检查并取病理活检·活榆标本病理确诊后予患侧输尿管肾全切术，肿瘤分期分级以术后大体手术标本病理为准。比较A、B两组间肿瘤大小、分期、分级的差异。结果：A组患者肿瘤直径为（2．6±1．5）cm显苦大于B组患者的（1．0±0．5）cm（P〈0．01）。A组患者E尿路上皮肿瘤临床分期亦较B组晚（P=0．020）。两组患者病理分级差异无统计学意义（P=0．075）。结论：输尿管软镜能发现传统影像学检查不能发现的甲期较小肿瘤．有望成为诊断上尿路上皮肿瘤常规检杏方式。

Clinical significance of flexible ureteroscopy in the diagnosis of upper urinary tract urothelial tumors

To investigate the clinical significances of flexible ureteroseopy in lhe diagnosis of upper urinary tract urotheliaI cell carcirlomas （UUT UCC）. Method： Fifty seven palients （34 males and 23 females） with a mean age of 67 years, were investigated by flexible uleroscopy during June 2006 and April 2012, all of them had preoperative radiological examinalions （CT scan plus IVP, or CTU）. According to the difference radiological fea lures, patients were divided into two groups： group A had radiologieal sign of tumor or ureleric obstruction, group R, had normal radiologieal performance. All of lhe patients had received flexible ureteroscopy and biospy were taken. Patient who was diagnosed as UUT UCC by pathology received radical nephroureterectom. Tumor size, pathological classification and Tumour Node Melastasis （TNM） classificalion were compared between gorup A and B. Result：The tumor diameler of group A（2.6± 1.5） cm is significantly lager than that of group B（ 1.0±0. 5） cm（ P〈0.01） , and the TNM slage of group A is laler lhan group B（ P=0. 020）, however, the palhologieal slage have no difference belween these two groups（ P=0. 075 ）. Conclusion： Flexible ureteroscopcy can observe smaller UUT UCC in their early TNM stage compare to radiological examinations, and it is expected to be a corn men practice for diagnosis of UUT UCC.