原发性输尿管癌诊治研究

Diagnosis and Treatment of Primary Ureteral Cancer

目的总结原发性输尿管癌的诊断和治疗经验。方法对北京医院2001～2007年收治的24例原发性输尿管癌的临床资料进行回顾性分析,比较各种检查方法和治疗手段,探讨诊治中存在的问题,总结诊治经验。结果术前确诊22例,19例行手术,术后病理报告18例为移行细胞癌,1例为移行细胞癌并小灶性鳞癌。结论联合应用B超、IVP、膀胱镜和逆行肾盂输尿管造影、尿脱落细胞、CT、MRI、输尿管镜等不同检查手段可提高术前明确诊断率,B超是基本筛查手段,膀胱镜+逆行肾盂输尿管造影是关键检查手段;治疗以手术为主,患侧肾-输尿管-膀胱袖状切除仍是治疗原发性输尿管癌的最佳选择;预后主要取决于肿瘤的分期、分级,提高早期诊断率具有重要意义。

Objective To discuss the diagnosis and treatment experience of primary ureteral cancer. Methods We retrospectively analyzed the clinical data of 24 patients with ureteral carcinoma treated in Beijing hospitals between 2001 -2007. Compared various examination methods and tried to figure out the existing problems in the diagnosis and treatment. Results The preoperative diagnosis of 22 in 24 cases were clarified, 19 of them received surgery. Postoperative pathology reports show of the 19 cases18 have pathology classification as transitional cell carcinoma, only 1 concurrent with small squamous cell carcinoma. Conclusion The combination of different examination method include B - type ultrasonic inspection, IVP, cystoscopy, retrograde pyelography, the detection of cancer cells from urine, CT, MRI and ureteroscopy can increase the preoperative diagnosis rate of primary ureteral carcinoma. The B -type ultrasonic inspection is a basic screening tool, cystoscopy ＋ retrograde pyelography check is the most important examination. Surgery is the major treatment. Sleeve resection of the affected kidney - ureter - bladder is the primary choice of treatment of ureteral cancer. The prognosis mainly depends on the tumor stage and grade, so improve early diagnosis of great significance.