膀胱粘膜增生性病变的临床及病理特点(附42例报告)

Clinical and pathological characteristics of proliferative bladder lesions (report of 42 cases)

目的 探讨膀胱粘膜上皮增生性病变的病因学及临床和病理特点。 方法 对 12 0例有下尿路刺激症状、排尿困难和血尿的患者进行尿道膀胱镜检和活检 ,结合病史、尿常规和尿动力学检查 ,对其中 4 2例膀胱粘膜上皮增生性病变进行分析。 结果 4 2例患者中 ,存在下尿路感染征象者 3 7例 ( 88% ) ,有下尿路梗阻表现者 2 4例 ( 5 7% ) ,下尿路梗阻患者均合并有感染。 3例合并移行细胞癌 ,1例尿细胞学检查发现癌细胞。 结论 膀胱粘膜上皮增生性病变 ,尤其是膀胱镜下粘膜无显著改变型增生性病变 ,是慢性下尿路感染和梗阻患者尿路上皮较常见的变异现象 ,慢性下尿路感染和梗阻可能是其致病原因。建议根据病变范围和组织学类型采取不同的治疗措施。

Objective To study the pathogenesis,clinical and pathological characteristics of proliferative lesions of the bladder. Methods 42 cases of proliferative lesions of the bladder were detected in 120 patients with complaints of frequency?urgency,hematuria and dysuria by means of cystoscopic biopsy of the suspicious foci in the bladder.with refences to the symptoms,urine routine and urodynamic, the relationship of the proliferative lesions of the bladder to the inflammation and obstruction of the lower urinary tract was analysed. Results Of the 42 cases of proliferative bladder lesions, 37(88%)have had lower urinary tract infection and 24(57%)with lower urinary tract obstruction.An obstructive bladder was always compliated by infection. 3 cases had occurrence of transitional cell carcinoma. Malignant cells were detected in the urine of 1 case. Conclusions Proliferative lesions of the bladder, especially without other obvious mucosa changes on cystoscopy, are common histological variants of urothelium in patients of chronic inflammation and obstruction of the lower urinary tract, and the latter may be the cause. It is suggested that different treatment strategy should be applicated according to the scope and histological type of the proliferative lesions.