摘要
膀胱癌是我国泌尿系统最常见的恶性肿瘤,新发病例中75%的病变局限于黏膜和固有层,临床分期属于T1期。其中10%的肿瘤病理分级属于G3级。把临床分期T1、病理分级G3的膀胱移行上皮癌统称为T1G3期膀胱癌。研究发现,T1G3期膀胱癌患者疾病进展和死亡的风险比其他T1期肿瘤患者高出10倍,其生物学行为复杂、临床预后较差,临床诊治相对较为棘手。目前国际上对于这类疾病多采取经尿道膀胱肿瘤电切联合膀胱灌注BCG保留膀胱、或根治性膀胱切除术的方式进行治疗。但何时选择保留膀胱的治疗方案、何时选择根治性膀胱切除术,还需要根据患者的具体临床风险因素进行综合分析,并制定最佳的治疗方案。作者在认真学习并总结国际上关于T1G3期膀胱癌最新治疗指南的基础上,对这类疾病的诊断与治疗的最新理念及方法进行综合分析,供广大泌尿外科同道参考。
Bladder cancer is the most common malignancy in urological system in China. 75% of the newly diagnosed tumors are confined in mucosa and lamina propria and they can be defined as clinical T1 stage, among which 10% is pathologi- cally defined as grade G3. Transitional cell carcinoma of bladder with clinical T1 stage and G3 pathological grade is defined as T1G3 bladder cancer. Researchers have demonstrated that the disease progression and mortality rate of the patients with TIG3 bladder cancer is 10 times higher than that of bladder cancer patients with other T1 stage. The complicated biological features with poor prognosis make T1G3 bladder cancer difficult to achieve an accurate diagnosis and better management. International- ly, the common treatment strategies include transurethral resection of bladder tumor combined with intravesical Bacillus Calmette-Guerin （BCG） instillation, and radical cystectomy. However, which patient and when to select bladder-sparing sur- gery or radical cystectomy should be carefully decided based on patients＇ risk factors, and then a best treatment strategy can be achieved. Based upon the careful reading and learning the renewed international guidelines, this review article is mainly focused on the summarizing and sharing of the latest ideas of the diagnosis and treatment methods for T1G3 bladder cancer with our do- mestic urologists.
出处
《现代泌尿外科杂志》
CAS
2012年第1期1-5,共5页
Journal of Modern Urology
关键词
膀胱癌
经尿道膀胱肿瘤电切
膀胱灌注
根治性膀胱切除
bladder cancer
transurethral resection of bladder tumor
bladder-sparing surgery
radical cystectomy
