肾盂癌(附36例报告)

CARCINOMA OF RENAL PELVIS (REPORT OF 36 CASES)

目的 :探讨肾盂癌的诊断和治疗方法 ,提高肾盂癌的诊治水平。方法 :回顾性分析 36例肾盂癌患者的临床资料。结果 :34例手术治疗 ,手术顺利 ,病理检查示移行细胞癌 32例 ,鳞癌 2例 ,肿瘤侵犯肾实质 31例 ,肾门淋巴结有转移 9例 ,侵犯肾包膜 9例 ,输尿管浸润 8例 ,膀胱发现肿瘤 2例 ,侵犯肾血管、腹主动脉 1例 ,侵犯肾上腺并出血 1例。随访 6月～ 11年 ,1年生存率 82 % ,5年生存率 5 5 .6 % ,平均生存 5 .3年 ,肿瘤侵犯膀胱者均定期膀胱镜检复查 ,膀胱内灌注化疗。结论 :肾盂癌诊断主要依靠临床表现及放射学检查 ,早期诊断 ,及时根治性肾、输尿管切除术是主要的治疗方法 ,应重视输尿管肾镜及经皮肾镜在诊治中的作用。

Objective:To improve the experience of diagnosis and treatment of carcinoma of renal pelvis.Method:The clinical date of 36 patients with carcinoma of renal pelvis admitted in our hospital were analysed retrospectively.Results:Thirty-four cases were treated surgically.The pathological type of 32 cases was transitional cell carcinoma,and of 2 cases was squamous cell carcinoma.Among them:31 cases invaded renal parenchyma,9 cases had metastatic reniportal nodes,9 cases invaded renal capsule,8 cases invaded ureter,2 cases found bladder tumors,1 case involoved renal vascularity and abdominal aorta,1 case involved adrenal gland and hemorrhage.All these patients were followed up for 6 months to 11 years,and the 1-year and 5-year survival rates were 82% and 55.6%.Conclusions:The diagnosis of carcinoma of renal pelvis mainly relies on clinical and radiographic present.Early diagnosis and total nephroureterectomy with removal of a cuff of periureteral bladder remains to be the choice of treatment for most cases.Ureterorenoscopy and percutaneous renoscopy are recommended for its treatment.