无症状膀胱肿瘤106例诊治分析

Diagnosis and treatment of 106 cases with asymptomatic bladder tumor

目的分析无症状膀胱肿瘤的临床表现、诊断与治疗特点。方法对106例无症状膀胱肿瘤患者诊断及治疗的临床资料进行回顾性分析。结果 106例膀胱肿瘤中有镜下血尿者42例。因体检B超发现96例,因其他疾患行下腹部CT平扫发现7例,以上103例均经膀胱镜检查证实,另外3例为膀胱镜下放置或拔除双J管时发现肿瘤。98例为上皮性肿瘤,均采取经尿道膀胱肿瘤电切术(TURBT)治疗;8例为非上皮性肿瘤,其中6例行膀胱部分切除术,2例行经尿道膀胱肿瘤电切术。平均随访2年,上皮性肿瘤复发6例,复发率6.12%(6/98),非上皮性肿瘤无一例复发,全组无死亡病例。结论无症状膀胱肿瘤包括非上皮性肿瘤和上皮性肿瘤,膀胱镜检查和活检是其诊断的金标准,多为良性肿瘤,恶性肿瘤者亦多为低分期、低分级肿瘤,TURBT配合术后膀胱灌注化疗可取得良好疗效,预后较好,复发率低。

Objective To analyze and summarize the clinical manifestation,diagnosis and treatment characteristics of patients with asymptomatic bladder tumor.Methods The clinical data of 106 patients with asymptomatic bladder tumor were retrospectively analyzed.Results Of 106 cases,42 cases of bladder tumors had microscopic hematuria,96 cases were found by medical ultrasound,and 7 cases were found by next abdominal CT scan line in other disorders,the above 103 cases were confirmed by cystoscopy,while 3 cases were found by placed under cystoscope or remoal of double J tube tumours.A total of 98 cases were urothelial tumors which were treated with transurethral resection of bladder tumor（TURBT）.Of eight cases of nonepithelial tumors,six patients underwent partial cystectomy,and two patients were treated with TURBT.After follow-up of mean 2 years,epithelial tumor recurrence occurred in six cases,and the overall recurrence rate was 6.12%（6/98）.No patients with non-epithelial tumor recurred.No patients died of bladder tumor.Conclusion Patients with asymptomatic bladder tumor include non-epithelial neoplasms and epithelial neoplasms.Cystoscopy and biopsy are the gold standard for diagnosis.Most of asymptomatic bladder tumors are benign urothelial tumors.Patients with malignant tumors also have low stage and low grade tumors,and TURBT combined with postoperative bladder perfusion chemotherapy can achieve good curative effect,good prognosis and low recurrence rate.