上尿路同时性和异时性上皮肿瘤的组织学和临床特征

The Histological and Clinical Features of Upper Urinary Tract Epithelial Tumors

目的:分析上尿路上皮肿瘤的组织学和临床特征及预后因素。方法:对60例同时性和异时性上尿路上皮肿瘤,进行回顾性总结及统计学分析。结果:单发肿瘤50例,多发10例,表浅型肿瘤18例(30.0%),浸润型42例(70.0%)。复发23例(38.3%),频率为0.76(0.15～1.71)次/年,平均间隔16.5个月。局部淋巴结转移3例,远处转移4例,其原发肿瘤均为浸润型。浸润型肿瘤或远处转移者预后较差,复发者中远期生存率较低。结论:尿路上皮肿瘤具有多发性和复发性的特点,应加强早期发现、早期诊断方面的研究。建议首次膀胱镜检查应在初诊后的第4个月,第二次间隔8个月,以后每年一次,持续10年。每两次膀胱镜检查之间,行超声波检查。

Objective:To study the histological and clinical features of upper urinary tract epithelial tumors,as well as its prognostic factors.Methods:Sixty patients with upper urinary tract epithelial tumors were analysed retrospectively.Results:Among these patients,50were single and10were multifocal tumors.It consisted of superficial type18(30.0%),invasive type42(70.0%).Twenty-three cases(38.3%)recurred with a mean interval time of16.5months and mean frequency of0.76(0.15～1.71)times /yr Three cases had local lymph node metastases and4cases had distant metastases.The patients with invasive type tumor or distant metastases and the recurrent patients had poor prognosis.Conclusion:Upper urinary epithelial tumor has the features of multifocal lesion and high recurrence rate.Early dicovery and treatment must be em-phasized.It is suggested that the first cystoscopy should be taken in the fourth month after ini-tial diagnosis and the second cystoscopy be performed8months later.After that,an annual cys-toscopy should be continued for10years,and ultrasonic examination should be taken in the in-terval of two cystoscopies.