摘要
背景与目的:对于是否需要在膀胱癌全膀胱切除术中常规进行输尿管残端冷冻活检,目前存在争议。本研究探讨输尿管残端冷冻活检在全膀胱切除术中应用的临床意义。方法:回顾性研究我院2002年5月至2006年5月间68例膀胱癌行全膀胱切除术患者的临床病理资料,并将冷冻活检与石蜡切片的结果进行了比较。中位随访时间为2.5年。结果:68例患者中,7例(10.3%)术中冷冻切片证实有一侧输尿管残端异常,其中6例为恶性肿瘤细胞侵润,1例为移行上皮不典型增生。7例患者术中均立即补充切除输尿管残端,并再次送冷冻活检,直到确诊无异常后,再行尿流改道。7例患者的冷冻切片诊断与最终的石蜡切片诊断均相符合。随访中有3例出现肿瘤复发与转移,但均未出现输尿管和肠道吻合口复发。结论:建议在膀胱癌全膀胱切除术中对输尿管残端进行冷冻活检,发现并彻底切除病灶,以改善预后。
Background and purpose： It is still controversial whether frozen section of ureteral residue during cystectomy will benefit bladder cancer patients in terms of the need of further treatment. The aim of this paper was to evaluate the clinical value of ureteral frozen section analysis during cystectomy. Methods： During May 2002 to May 2006, 68 patients with invasive bladder cancer underwent radical cystectomy in the Cancer Hospital of Fudan University. The results of intraoperative analysis of frozen sections and postoperative histological analysis were compared. The median follow-up period was 2.5 years. Results： 7 of 68 patients （10.3%） had evidence of ureteral abnormality on frozen section, 1 of 7 was mild atypia, other 6 was carcinoma in situ involving the distal ureter. All of the 7 patients received additional ureteral resection before urinary diversion until negative ureteral margins were achieved. The results of frozen section analysis were in accordance with that of final histological analysis. 3 patients experienced upper tract recurrence during the follow-up period. Conclusions： Ureteral frozen section analysis during cystectomy is recommended, it might be possible to improve the prognosis in bladder cancer patients since further treatment was warranted.
出处
《中国癌症杂志》
CAS
CSCD
2007年第3期252-254,共3页
China Oncology
