肾盂癌14例诊断与治疗分析

DIAGNOSIS AND TREATMENT ANALYSIS OF 14 CASES CARCINOMA OF RENAL PELVIS

目的：提高肾盂肿瘤的诊治水平。方法：回顾性总结１９８３－１９９９年手术和病理证实的原发性肾盂移行细胞癌１４例，对其临床特点及各种检查方法的选择进行分析，并对其误诊原因进行讨论。结果：术前明确诊断１２例，为８５．７１％。１４例病理检查证实为肾盂移行细胞乳头状细胞癌，其中Ｇ１级２例，Ｇ２级９例，Ｇ３级３例；Ⅰ期３例，Ⅱ期７例，Ⅲ例２例，Ⅳ期２例。得到随访１２例，无瘤生存１１个月～１４ａ。结论：血尿。

Objective:To improve the diagnosis and treatment of pyelic neoplasms.Methods:14 cases of primary pyelic transitional cell carcinoma verified through operation and pathology from 1983 to 1999 were reviewed.The clinical features and the choice of methods for examination were analyzed.And the causes of misdiagnosis were discussed.Results:12 cases were diagnosed definitely before operation (85.71%).14 cases were verified to be pyelic transitional cell papilloma through pathology.2 cases were in G 1,9 cases were in G 2,3 cases were in G 3,3 cases were in stage Ⅰ,7 cases were in stage Ⅱ,2 cases were in stage Ⅲ,2 cases were in stage Ⅳ.And 12 cases were given postoperative follows up.The disease-free interval were 11 months to 14 years.Conclusions:Hematuria,flank pain and hydronephrosis were the main presentations of these patients.The combined application of examinations such as IVU,ultrasonography,retrograde pyelography,CT scanning,cystourethroscope,urine cytology etc before operation may improve the rate of correct diagnosis of pyelic carcinoma.The radical sleeve resection of kidney,ureter and bladder was the effective method for the treatment of pyelic carcinoma.