原发性输尿管癌的诊断和处理(附47例报告)

The diagnosis and treatment of primary ureteral cancer

目的 提高原发性输尿管癌的诊治水平。 方法 回顾性分析４７ 例经病理证实的原发性输尿管癌病例，对诊治中的若干问题进行探讨。 结果 肉眼血尿、腰痛和肾积水是本病三大临床表现，ＣＴ、Ｂ超和尿细胞学检查的阳性率分别为５７．１％ 、４０ ．９ ％ 和３７ ．０ ％ ，４２ 例患者分别接受了５种手术治疗，３４ 例获得随访，５ 年生存率为３３ ．３％ 。 结论 重视老年人单侧腰痛和肾积水可能早期诊断原发性输尿管癌，对不明原因的肾积水应追查其原因，老年人输尿管息肉和输尿管狭窄病变应慎重处理。

Objective To improve the diagnosis and treatment of primary ureteral cancer. Me thods 47 cases of primary ureteral cancer treated in the last decade were reviewed.Several aspects of the diagnosis and treatment were probed into. Results Hematuria, flank pain and hydronephrosis were the main presentations of these patients.The positive rates of ultrasonography,CT scanning and urine cytology were 40.9%,57.1% and 37.0% respectively.42 patients have been operated(5 surgical choices) and the 5 year survival rate was 33.3%. Conclusions Attention paid to unilateral flank pain and hydronephrosis and thorough investigation for cause unknown hydronephrosis or ureteral stricture were the key points for the early diagnosis of primary ureteral cancer.