原发性输尿管癌的诊断与治疗(附28例报告)

Diagnosis and treatment of primary ureteral carcinoma (Report of 28 cases)

目的：提高原发性输尿管癌的诊治水平。方法：结合有关文献分析1984年1月～1997年7月收治的28例原发性输尿管癌的临床特点、诊断、治疗及预后并进行讨论。结果：28例术后均经病理检查证实。首发症状以肉眼血尿最常见，膀胱镜检、逆行输尿管造影和输尿管镜检查是最重要的诊断方法，治疗以手术为主。28例中l7例获得随访，其中9例无瘤生存，8例死亡。结论：原发性输尿管瘤预后与肿瘤的分级、分期密切相关，早期诊断、合理的治疗和预防复发是提高患者生存率的关键。

Purpose:To improve the diagnosis and treatment of primary ureteral carcinoma.Methods:The clinical characteristic, diagnosis, treatment and prognosis of primary ureteral carci-noma were discussed with literature in 28 patients from Jan. 1984 to July 1997. Results:All caseswere proved by pathological diagnosis after operation. The common symptom was painless grosshematuria. The main diagnostic methods were cystoscopy, retrograde ureteropyelography andureteroscopy. Operation was chief treatment measure. 17 in 28 cases were followed ─ up. 9 pa-tients were survival with no tumor, the others died. Couclusious:The prognosis of primary ureteralcarcinoma was relevant to the grade and stage of tumor. lt is key to improve survival rates that ear-ly diagnosis,, reasonable treatment and prevention of recurrence.