21例原发性输尿管癌的临床诊治分析

Clinical analyses on the diagnosis and treatment of 21 cases of primary carcinoma of ureter

目的 提高原发性输尿管癌的诊断水平和治疗效果。方法 回顾总结 1 977年 6月至 2 0 0 0年 3月收治的 2 1例原发性输尿管癌的临床资料。结果 2 1例均为移行细胞癌 ,其中 1级 4例、2级 1 1例、3级 6例。Ta 1期 7例、T2期 1 1例、T3～ 4期 3例。随访 1 7例 ,失访 4例。随访时间 5个月至 1 3年。其中 1年内死亡 5例 ,1年至 5年死亡 6例 ,存活超过 5年 6例 ,5年生存率35.2 9%。结论 膀胱镜 +逆行肾盂造影及输尿管镜可明显提高术前确诊率 ;治疗以肾、输尿管、膀胱袖套状切除为主 ,术后BCG、化疗药物行膀胱或肾盂灌注治疗是预防肿瘤复发的最好方法。

Objective To improve the diagnosis and treatment of primary malignant tumor of ureter. Methods From Jun. 1977 to Mar. 2000, 21 cases of primary malignant tumor of ureter have been treated and followed up. The diagnosis,treatment and late follow up results were analysed retrospectively. Results All cases were transitional cell carcinoma. 17 cases were followed up from 5 months to 13 years, the 5 years survival rate was 35.29%. Conclusions The rate of confirmed diagnosis can be raised by cystoscopy, retrograde pyelography and ureteroscopy pre operatively. The main treatment is partial nephrounetenocystectomy. The instillation of BCG and chemical drugs into bladder or renal pelvis is the best way to prevent recurrence of tumors.