膀胱腺癌诊断及治疗的临床分析(附32例报告)

The clinical analysis in the diagnosis and treatment of bladder adenocarcinoma (report of 32 cases)

目的探讨膀胱腺癌的临床诊治方法及效果。方法回顾性比较分析32例膀胱腺癌患者的诊治方式及疗效。结果 32例患者均行手术治疗,术后病理均证实为膀胱腺癌。比较B超、静脉尿路造影(IVU)、CT、膀胱镜、尿脱落细胞学检查,术前膀胱镜诊断符合率最高为100%。24例获得随访,时间6个月～7年,12例膀胱部分切除(扩大范围)患者>5年生存率为66.7%(8/12);10例根治性膀胱全切者>5年生存率为40.0%(4/10);2例行TURBT治疗,其中1例己复发,1例死于肿瘤进展。结论膀胱腺癌的早期诊断非常重要,肿瘤部位、大小决定手术方式,膀胱部分切除(扩大范围)加术后化疗是一种理想的治疗方法。

Objective To discuss the effect in the clinical diagnosis and treatment of bladder adenocarcinoma.Methods The treatments and prognosis of 32 patients suffering from bladder adenocarcinoma were retrospectively analysed.Results All the 32 cases were testified adenocarcinoma by pathology postoperatively.Preoperative diagnostic accuracy of cystoscopy was 100%,being verified by ultrasound,IVU,CT scanning,cystoscopy and cytology for all cases.24 patients were followed up for 0.5-7years.In the ampliative partial cystectomy group,8 of 12 cases （66.7%） survived more than 5 years.Inradical cystectomy group,4 of 10 cases （40%） survived more than 5 years.TURBT was performed in 2 patients.One case was identified to be recurrent and the other died from cancer progression.Conclusions Early diagnosis for patient of bladder adenocarcinoma is the very important.The operative treatment depends on the location and size of tumor.For early stage of bladder adenocarcinoma,partial cystectomy associated with chemotherapy postoperatively may be the optimal therapy.