膀胱腺癌的诊断与处理(附41例报告)

Diagnosis and treatment of adenocarcinoma of urinary bladder (reports of 41 cases)

目的 提高膀胱腺癌的诊断与治疗水平。 方法 分析经手术病理证实的 4 1例膀胱腺癌患者资料。原发性膀胱腺癌 18例 ,作全膀胱切除 +尿流改道 8例 ,膀胱部分切除 10例 ;脐尿管腺癌 12例中扩大膀胱部分切除 11例 ;转移性腺癌 11例均切除膀胱病灶。 结果 膀胱腺癌占同期膀胱癌的 3.2 %。 37例随访 5个月～ 10年 ,1年生存 19例 (5 1.3% ) ,2年生存 16例 (43.2 % ) ,5年生存 8例 (2 1.6 % )。 结论 原发性膀胱腺癌宜行根治性全膀胱切除术 ,脐尿管腺癌应作扩大性膀胱部分切除 ,对复发、转移性患者应采用综合治疗 。

Objective To study the diagnosis accuracy and the treatment sequelae of adenocarcinoma of urinary bladder. Methods 41 cases of urinary bladder adenocarcinoma have been encountered from 1980 to 2000,all of them had undergone operation and the diagnosis being assessed on histopathology studies.There are 18 cases of primary bladder adenocarcinoma,among which 8 had undergone radical cystectomy and 10 partial cystectomy.Among 12 cases of urachal adenocarcinoma extending to the bladder,11 received extended resection.All the 11 patitents with metastatic focus in the bladder underwent local ablation. Results Urinary bladder adenocarcinoma comprised 3.2% of the bladder cancer.Thirty seven patients have been followed up for five months to ten years.The 1 year survival rate was 51.3%(19 cases),the 2 year survival rate 43.2%(16 cases) and the 5 year survival rate 21.6%(8 cases). Conclusions Radical total cystectomy is the treatment of choice for primary adenocarcinoma of bladder and extended partial cystectomy seems to be the best for urachal adenocarcinoma. Comprehension therapy should be undertaken for patients with metastatic adenocarcinoma or tumor recurrence so as to improve the survival rate.