综合治疗膀胱混合癌的临床观察

Clinical study of multimodality appoaches for the bladder mixed tumor

目的 分析膀胱混合癌配合体部伽玛刀等综合治疗的疗效.方法 报告2003年7月至2013年8月本院收治的17例膀胱混合癌患者的临床资料,结合文献对该病的临床表现、诊断、治疗和加全身伽玛刀综合治疗以及预后情况进行讨论.结果 膀胱混合癌占同期362例膀胱恶性肿瘤的4.4％,移行、腺细胞混合癌5例,移行、鳞状细胞混合癌8例,移行、鳞状、腺细胞混合癌2例,鳞状、腺细胞混合癌2例.以膀胱刺激征和肉眼血尿为主要临床表现,治疗以膀胱全切和部分切除为主,术后辅助化疗或放疗,其1、3和5年的生存率分别为90.6％、52.8％和35.3％.结论 膀胱混合癌的恶性程度高,早期诊断和治疗是提高生存率的关键.全身伽玛刀配合手术及化疗等综合治疗有助于改善预后,提高生存率.

Objectives To study the clinical effect of whole body γ-knife and multimodality appoaches on the bladder mixed tumor.Methods 17 case treated from jun 2003 to Aug 2013 were reviewed.The clinical manifestations,diagnosis,treatment,whole body γ-knife and multimodality appoaches and prognosis were discussed.Results 17 case of the bladder mixed tumor accounted for 4.4％ of 362 bladder tumor patients in the same period,of which 5 of 17 were transitional squamous cell carcinoma,8 transitional adenocarcinoma,2 transitional squamous adenocarcinoma and 2 squamous adenocarcinoma a mixed tumor.Most of the patients had irritable bladder symptoms and hematurine.The main treatment was partial or total cystectomy.The over survival rates at 1,3 and 5a years post operation were 90.6％,52.8％ and 35.3％ respectively.Conclusions There wer higher malignancy and worse prognosis in bladder mixed tumor.Early diagnosis and therapy might prolong survival.Radical total cystectomy,whole body γ-knife and muhimodality appoaches on the bladder mixed tumor seems to be the best method of treatment.