膀胱移行细胞癌术后的异时性上尿路肿瘤

Upper urinary tract tumors developing after bladder transitional cell cancer

目的：探讨膀胱癌术后上尿路上皮肿瘤的发生率和临床特征,提高异时性上尿路肿瘤的诊治水平。方法：对422例浅表性膀胱癌(低危178例,中危136例,高危108例)和215例浸润性膀胱痛患者术后上尿路上皮性肿瘤的发生情况及临床特点进行分析。结果：637例膀胱癌患者发生异时性上尿路肿瘤16例,其中浅表组10例,浸润组6例。浅表组和浸润组、浅表高危组和中危组间差异无统计学意义(P＞0．05),浅表中危、高危组与低危组差异有统计学意义(P＜0．05)。16例上尿路肿瘤患者均行肾输尿管全长切除术,术后3例死于肿瘤转移和复发。结论：膀胱肿瘤的病理分级、肿瘤数目、原位癌等是发生异时性上尿路肿瘤的危险因子,浸润性膀胱癌术后发生上尿路肿瘤的预后较浅表性者差。

Objective： To study the incidence and characteristics of metachronous upper urinary tract transitional cell cancer（UUT TCC） in patients whh primary bladder tumor, and evaluate the characteristics of bladder tumors related to UUT TCC, Methods： We retrospectively studied the incidence and clinic characteristic of UUT TCC among 637 cases of bladder tumor （ 122 with superficial bladder cancer and 215 with invasive bladder cancer）. Results： 16 cases were dcveloped will metachronous UUT TCC （ 10 patients were in superficial group and 6 patients in invasive group）, The incidence of UUT TCC was not statistically significant（ P 〉0.05）between superficial group and invasive group, the same result was attained between intermediate risk group and high risk group in superficial bladder cancer. The meidence of UUT TCC were significantly higher in patients at intermediate risk and high risk group titan in those at low risk （ P〈 0.05 ）. Conclusions： High tumor pathologic stages., tumor multiplicity, concomitant carconma in situ were risk factors related to metachronous UUT TCC after diagnosis and treatment of primary bladder cancer. UUT TCC after treatment of invasive bladder cancer tends to have a relatively poor prognosis.