上尿路结石并发膀胱肿瘤5例报告并文献复习
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摘要
目的探讨上尿路结石并发膀胱肿瘤的临床特点及疗效。方法回顾性分析北京市垂杨柳医院2010年10月至2016年10月在上尿路结石术中发现膀胱肿瘤的5例患者的临床资料。其中男4例,女1例,年龄50～67岁,平均56.8岁;肾结石1例,输尿管结石1例,肾结石合并输尿管结石3例;左侧2例,右侧1例,双侧2例。所有患者均行泌尿系彩超、泌尿系平片、静脉尿路造影和(或)泌尿系CT检查,术前均未能诊断合并膀胱肿瘤。结果 5例患者肿瘤均为单发,位于膀胱颈1例,膀胱三角区3例,膀胱左侧壁1例,均给予经尿道膀胱肿瘤等离子电切术治疗,术后病理提示腺性膀胱炎1例,尿路上皮乳头状瘤2例,低度恶性潜能尿路上皮乳头状瘤2例。5例患者均获随访,随访时间31～71个月,平均50.4个月,未见肿瘤复发。结论上尿路结石术中应充分注意活组织病理检查的重要性,尤其是膀胱镜检查的重要性。
Objective To investigate the clinical characteristics and effect of vesical carcinoma secondary to upper urinary tract stones.Method A retrospective study of 1177 cases of upper urinary tract stones in our hospital from October 2010 to October 2016 was madeand 5 cases of vesical carcinoma were found in the operations. There were 4 males and 1 female aged from 50 to 67 years old with medianage of 56.8 years. 1 kidney stone case, 1 ureteral stone case and 3 cases of kidney with ureteral stone(2 on the left, 1 on the right, 2 on bothsides) were all examined by utrasonography, intravenous urography and computed tomography, and the evidence of vesical carcinoma wasnot found. Result The vesical tumor located at bladder neck(1 case), bladder trigone(3 cases) and left wall(1 case) who were admittedwith transurethral resection in saline method.1 patient had glandular cystitis, 2 patients had papillary urothelial neoplasms, and the other 2 patients had papillary urothelial neoplasms of low malignant potential. Cystoscopic examination and follow-up in 31 to 71 months(median50.4 months) showed no signal relapse. Conclusion It is very important to have a regular cystoscopic examination before the operation ofupper urinary tract stones.
Objective To investigate the clinical characteristics and effect of vesical carcinoma secondary to upper urinary tract stones.Method A retrospective study of 1177 cases of upper urinary tract stones in our hospital from October 2010 to October 2016 was madeand 5 cases of vesical carcinoma were found in the operations. There were 4 males and 1 female aged from 50 to 67 years old with medianage of 56.8 years. 1 kidney stone case, 1 ureteral stone case and 3 cases of kidney with ureteral stone(2 on the left, 1 on the right, 2 on bothsides) were all examined by utrasonography, intravenous urography and computed tomography, and the evidence of vesical carcinoma wasnot found. Result The vesical tumor located at bladder neck(1 case), bladder trigone(3 cases) and left wall(1 case) who were admittedwith transurethral resection in saline method.1 patient had glandular cystitis, 2 patients had papillary urothelial neoplasms, and the other 2 patients had papillary urothelial neoplasms of low malignant potential. Cystoscopic examination and follow-up in 31 to 71 months(median50.4 months) showed no signal relapse. Conclusion It is very important to have a regular cystoscopic examination before the operation ofupper urinary tract stones.
引文
[1]孔垂泽,李军,孙志熙,等.膀胱偶发癌(附39例报告)[J].中华泌尿外科杂志,2003,24(12):834-835.
[2]李王坚,尚庆亚,陈永良.影像学阴性膀胱偶发肿瘤8例诊治分析[J].浙江实用医学,2015,20(2):101-102.
[3]陈桦,胡建敏.泌尿系结石合并肿瘤109例诊治体会[J].医学理论与实践,2012,25(4):430-431.
[4]Chow WH,Lindblad P,Gridley G,et al.Risk of urinary tract cancers following kidney or ureter stones[J].J Natl Cancer Inst,1997,89(19):1453-1457.
[5]Chung SD,Liu SP,Lin HC.A population-based study on the association between urinary calculi and kidney cancer[J].Can Urol Assoc J,2013,7(11-12):E716-E721.
[6]Ham BK,Kim JW,Yoon JH,et al.Squamous cell carcinoma must be considered in patients with long standing upper ureteral stone and pyonephrosis[J].Urol Res,2012,40(4):425-428.
[7]Verma N,Yadav G,Dhawan N,et al.Squamous cell carcinoma of kidney co-existing with renal calculi:a rare tumour[J].BMJ Case Rep,2011,2011:bcr1020103388.
[8]李传章.泌尿系结石合并肿瘤50例诊治体会[J].中国卫生产业,2013,10(19):168-170.
[9]张世林,叶定伟,姚旭东,等.膀胱偶发肿瘤的诊断与治疗[J].中国癌症杂志,2007,17(3):255-257.
[10]李博,金讯波.替代性膀胱灌注治疗卡介苗无效的非肌层浸润性膀胱癌[J].中国医刊,2017,52(11):7-11.
[2]李王坚,尚庆亚,陈永良.影像学阴性膀胱偶发肿瘤8例诊治分析[J].浙江实用医学,2015,20(2):101-102.
[3]陈桦,胡建敏.泌尿系结石合并肿瘤109例诊治体会[J].医学理论与实践,2012,25(4):430-431.
[4]Chow WH,Lindblad P,Gridley G,et al.Risk of urinary tract cancers following kidney or ureter stones[J].J Natl Cancer Inst,1997,89(19):1453-1457.
[5]Chung SD,Liu SP,Lin HC.A population-based study on the association between urinary calculi and kidney cancer[J].Can Urol Assoc J,2013,7(11-12):E716-E721.
[6]Ham BK,Kim JW,Yoon JH,et al.Squamous cell carcinoma must be considered in patients with long standing upper ureteral stone and pyonephrosis[J].Urol Res,2012,40(4):425-428.
[7]Verma N,Yadav G,Dhawan N,et al.Squamous cell carcinoma of kidney co-existing with renal calculi:a rare tumour[J].BMJ Case Rep,2011,2011:bcr1020103388.
[8]李传章.泌尿系结石合并肿瘤50例诊治体会[J].中国卫生产业,2013,10(19):168-170.
[9]张世林,叶定伟,姚旭东,等.膀胱偶发肿瘤的诊断与治疗[J].中国癌症杂志,2007,17(3):255-257.
[10]李博,金讯波.替代性膀胱灌注治疗卡介苗无效的非肌层浸润性膀胱癌[J].中国医刊,2017,52(11):7-11.