膀胱混合癌的诊断和治疗

Diagnosis and Treatment of the Bladder Mixed Tumor

目的探讨膀胱混合癌的诊治方法.方法报告1990年6月至2004年8月我院收治的16例患者的临床资料,结合文献对该病的临床表现、诊断和治疗以及预后情况进行讨论.结果膀胱混合癌占同期230例膀胱恶性肿瘤的6.9%,移行、腺细胞混合癌3例,移行、鳞状细胞混合癌4例,移行、鳞状、腺细胞混合癌1例,鳞状、腺细胞混合癌2例.以膀胱刺激症和肉眼血尿为主要临床表现,治疗以膀胱全切和部分切除为主,其1、3和5 a的生存率分别为81.3%、56.3%和12.5%.结论膀胱混合癌的恶性程度高,早期诊断和治疗是提高生存率的关键.根治性全膀胱切除术有助于改善预后,提高生存率.

Objective To elucidate the diagnosis and treatment of the bladder mixed tumor. Methods 16 cases treated from Jun 1990 to Aug 2004 were reviewed. The clinical manifestations, diagnosis, treatment and prognosis were discussed. Correlative literature was reviewed at the same time. Results 16 cases of the bladder mixed tumor accounted for 6. 9% of 223 bladder tumor patients in the same period, of which 7 of 16 were transitional squamous cell carcinoma, 4 transitional adenocarcinoma, 3 transitional squamous adenocarcinoma and 2 squamous adenocarcinoma mixed tumor. Most of the patients had irritable bladder symptoms and hematurine. Partial cystectomy was undergone for 3 of 16 cases, total cystectomy for 10 and radical total cystectomy for 3. The main treatment was partial or total cystectomy. The overall survival rates at 1, 3 and 5 years post operation were 81.3%, 56. 3% and 12. 5% respectively. Conclusion There were higher malignancy and worse prognosis in bladder mixed tumor. Early diagnosis and therapy might prolong survival. Radical total cystectomy seems to be the best method of treatment.