原发性输尿管癌18例报告

Primary Carcinoma of Ureter A Report of 18 Cases

报告原发性输尿管癌１８例，临床主要表现为血尿和腰痛。术前明确诊断１５例，误诊３例。１８例均行手术治疗，病理报告１７例为移行细胞癌，１例为移行细胞癌并小灶性鳞癌。１８例均得到随访。原发性输尿管癌发病率远较泌尿系其它部位上皮肿瘤发病率低，这可能与尿液在输尿管停留时间较短有关，肿瘤绝大多数位于输尿管下段，其诊断较为困难，认为泌尿系造影、膀胱镜检查是诊断输尿管癌的主要方法，尤其是逆行造影。手术以半泌尿系切除＋膀胱袖状切除为佳，术后常规行膀胱ＢＣＧ灌注，能达到预防膀胱肿瘤复发的目的。

cases of primary carcinoma of ureter were reported The main clinical manifestations were hematuria and lumbar pain Diagnosis was confirmed in 15 cases prior to surgcal operation Surgical management was carried out in all of the 18 cases Pathological examination showed that all of the 18 cases were transitional cell carcinoma except one combined with small foci of squamous cell carcinoma All of the 18 cases have been followed up The incidence of primary carcinoma of ureter is much lower than that of the other urinary epithelial tumors,perhaps this is related to the fact that urine only retains in ureter for a very short period of time The majorities of the tumors located at the lower portion of the ureter so it was more difficult to establish the diganosis Urography,especially retrograde urography,and cytoscopy have been the chief methods to diagnose carcinoma of ureter The operative procedure of choice was nephroureterectomy combined with partial cystectomy BCG instillation of bladder was carried out routinely following surgical operation to avoid recurrence of tumors of bladder