上尿路结石并发膀胱肿瘤5例报告并文献复习

Vesical carcinoma secondary to upper urinary tract calculi: A report of 5 cases and literature review

目的探讨上尿路结石并发膀胱肿瘤的临床特点及疗效。方法回顾性分析北京市垂杨柳医院2010年10月至2016年10月在上尿路结石术中发现膀胱肿瘤的5例患者的临床资料。其中男4例,女1例,年龄50～67岁,平均56.8岁;肾结石1例,输尿管结石1例,肾结石合并输尿管结石3例;左侧2例,右侧1例,双侧2例。所有患者均行泌尿系彩超、泌尿系平片、静脉尿路造影和(或)泌尿系CT检查,术前均未能诊断合并膀胱肿瘤。结果 5例患者肿瘤均为单发,位于膀胱颈1例,膀胱三角区3例,膀胱左侧壁1例,均给予经尿道膀胱肿瘤等离子电切术治疗,术后病理提示腺性膀胱炎1例,尿路上皮乳头状瘤2例,低度恶性潜能尿路上皮乳头状瘤2例。5例患者均获随访,随访时间31～71个月,平均50.4个月,未见肿瘤复发。结论上尿路结石术中应充分注意活组织病理检查的重要性,尤其是膀胱镜检查的重要性。

Objective To investigate the clinical characteristics and effect of vesical carcinoma secondary to upper urinary tract stones.Method A retrospective study of 1177 cases of upper urinary tract stones in our hospital from October 2010 to October 2016 was madeand 5 cases of vesical carcinoma were found in the operations.There were 4 males and 1 female aged from 50 to 67 years old with medianage of 56.8 years.1 kidney stone case,1 ureteral stone case and 3 cases of kidney with ureteral stone(2 on the left,1 on the right,2 on bothsides) were all examined by utrasonography,intravenous urography and computed tomography,and the evidence of vesical carcinoma wasnot found.Result The vesical tumor located at bladder neck(1 case),bladder trigone(3 cases) and left wall(1 case) who were admittedwith transurethral resection in saline method.1 patient had glandular cystitis,2 patients had papillary urothelial neoplasms,and the other 2 patients had papillary urothelial neoplasms of low malignant potential.Cystoscopic examination and follow-up in 31 to 71 months(median50.4 months) showed no signal relapse.Conclusion It is very important to have a regular cystoscopic examination before the operation ofupper urinary tract stones.