慢性马兜铃酸肾病患者伴发泌尿系统肿瘤

Urothelial carcinoma in patients with chronic aristolochic acid nephropathy

目的探讨慢性马兜铃酸肾病患者伴发泌尿系肿瘤情况。方法回顾分析102例慢性马兜铃酸肾病患者中4例伴发泌尿系肿瘤患者的临床资料。结果(1)4例患者均有长期间断小剂量服含马兜铃酸药物史,并被确诊为慢性马兜铃酸肾病,慢性肾功能不全;(2)4例均有明显血尿,相差显微镜检查呈均一红细胞尿,其中2例有肉眼血尿;(3)膀胱镜检查、逆行尿路造影及手术证实,3例为膀胱乳头状移行细胞癌,1例为肾盂移行细胞癌。结论慢性马兜铃酸肾病患者若出现明显均一红细胞血尿时,即应高度警惕泌尿系肿瘤发生。

Objective To investigate the urothelial carcinoma in patients with chronic aristolochic acid nephropathy(CAAN). Methods The clinical data of urothelial carcinoma were analyzed in 4 cases among 102 patients with CAAN. Results (1)Chronic renal insufficiency caused by CAAN was diagnosed in 4 patients after intermittently taking the medicine containing aristolochic acid(AA) for a long time (from 3 years to 24 years). (2) Urinary examination of these 4 cases showed the red cells with uniformed shape. Two of them experienced an episode of macroscopic haematuria. (3) Three of them had papillary transitional cell carcinomas on the bladder wall by the cystoscopy and pathological examination. The other one had carcinoma of the left renal pelvis by the retrograde urography and pathological examination after surgical operation. Conclusion CAAN is associated with the developing urothelial tumours when a patient with CAAN has an episode of macroscopic or obvious microscopic hematuria with red cells of uniformed shape.