二次电切诊治早期原发性膀胱腺癌七例临床分析

Clinical research of second resection on early stage primary bladder adenocarcinoma and literature review

目的探讨原发性膀胱腺癌的临床病理特点及早期原发性膀胱腺癌的诊治方法。方法回顾性分析了2010年1月至2015年7月南通大学附属医院泌尿外科诊治原发性膀胱腺癌7例患者的临床特点、病理学结果、诊治及随访情况，并结合相关文献进行探讨研究。结果本组7例病例，经第一次电切手术病理确认：T1期6例，他期1例；1个月后行第2次电切手术，除1例患者改开放根治性膀胱切除，其余行电切手术且病理未发现异常，术后辅助放化疗，随访至2016年1月，仅1例患者死亡，患者最长生存期已达72个月。结论原发性膀胱腺癌恶性度高，早期发现的患者根据第2次电切手术结果进一步安排诊治方案，在不影响生存率的情况下提高了患者生存质量。

Objective To investigate the clinical and pathological characteristics, as well as the diagnosis and treatment of primary bladder adenocarcinoma in the early stage. Methods The clinical features, pathological resuhs, diagnosis and treatment profiles of 7 cases of primary bladder ad admitted in Affiliated Hospital of Nantong University from January 2010 to July 2015 were analyzed ret rospectively. Results All seven cases were diagnosed pathologically as primary bladder adenocarinoma. Histological staging T1 was revealed in six cases, while T2 in one case after the first resection. After four weeks, all patients received the second resection while one patient underwent immediately radical cystectomy. Muhimodality therapy such as radiotherapy or chemotherapy was performed for longer postoperative survival, only one man died while another patient had been healthy for 6 years till January 2016. Conclusion Primary bladder adenocarcinoma is a highly malignant disease in bladder cancer. According to the results of the second resection, multimodality therapy for patients in early stage with no lymph node or other organs metastasis can improve the quality of life without affectiong their lives.