摘要
目的揭示脐尿管肿瘤的临床特征,提高其诊治水平。方法分析16例脐尿管肿瘤的临床资料。结果男14例,女2例;平均年龄(52.0±4.5)岁。肉眼血尿11例,血尿伴尿频尿急5例,血尿时间中位数3.5个月。尿中有黏液者6例。肿瘤直径平均(6.0±1.2)cm,盆腔淋巴结转移4例。TNM分期:T2 2例,T3 10例,T4 4例。临床分级:G1 2例,G2 12例,G3 2例。均行扩大性膀胱部分切除术,术后病理诊断黏液性腺癌10例,混合癌3例,乳头状腺癌2例,小细胞型内分泌癌1例。术后IL-2治疗2例,羟基喜树碱膀胱灌注3例,M-VAC方案化疗1例。16例患者均获随访,随访3个月~11年,平均(28±3)个月。术后1年期生存率为50%(8/16),5年期生存率为18.25%(3/16)。T2期患者的5年生存率明显高于T3、T4期患者。5例小于50岁的脐尿管癌患者均自青少年时期就开始大量吸烟。结论血尿是脐尿管癌的最常见症状,扩大性膀胱切除术为标准手术方式,复发转移者应采取综合治疗。过早大量吸烟可能是脐尿管癌的一个危险因素。早诊、早治对脐尿管癌的长期存活有重要意义。
Objective To reveal the clinical feature of urachal carcinoma and improve its diagnosis and treatment. Methods Clinical and follow-up data of 16 patients with urachal carcinoma were reviewed. Results 14 cases were male, 2 were female, mean age (52.0 ± 4.5) years. Periodical and painless gross hematuria, urgency and frequency of urination and mucus in urine were the common clinical manifestations in these patients. CT scanning showed the mean diameter of carcinoma was (6.0 ± 1.2) cm. Metastases involved pelvic cavity lymph nodes were noted in 4 cases. TNM clinical stage:T2 2 cases, T3 10 cases,T4 4 cases. All of the 16 patients underwent extensive partial excision of bladder. No patient died during operation and no complication occurred after operation. The pathological results were mucoid adenocarcinoma 62. 5% (10/16), mixed carcinoma (adenocarcinoma mixed with partial transitional cell carcinoma) 18.75% (3/16) ,papillary adenoearcinoma 12.5%(2/ 16) ,and smell cell endocrine carcinoma 6.25% (1/16). After operation, 2 cases received IL-2 for biological therapy, 3cases received hydroxycamptothecin for bladder irrigation, and smell cell endocrine carcinoma case received M-VAC chemotherapy. All cases were followed up from 3 to 132 months, mean (28 ± 3) months. The 1-year and 5-year survival rates of all cases were 50% (8/16) and 18.25% (3/16). Five cases are alive now. A female patient who received IL-2 biological therapy has lived 11 years now. Fifty percent (8/16) of the patients had recurrence or metastasis post-operation, and the median time was 8 months. Most of the recurrent cases lost the chances for a second operation and could receive only alleviative treatment. All of the five cases whose age of onset was less than 50 had a history of smoking from adolescence. Conclusion Hematuria is the common clinical manifestation in these patients. Extensive partial excision of the bladder is the first choice of treatmend for urachus carcinoma. Combined modality should be
出处
《现代泌尿外科杂志》
CAS
2010年第3期180-183,共4页
Journal of Modern Urology
关键词
脐尿管癌
诊断
治疗
预后
urachus carcinoma
diagosis
therapy
prognosis