摘要
目的:探讨非血吸虫性膀胱鳞状细胞癌的病因、诊断、治疗及预后情况。方法:回顾分析21例经术后病理检查证实为膀胱鳞癌患者的临床资料,包括其临床症状、检查、治疗及预后情况,对其预后情况进行相关的统计分析。结果:21患者中主要症状表现为血尿、膀胱刺激症状、泌尿系感染等。患者1年、2年及5年生存率分别为55%、30%和5%,中位生存期16.1个月。初次就诊时T1期0例,4例发现盆腔淋巴结转移,1例发现肺部转移。接受根治性膀胱全切的患者生存期明显长于未行根治性膀胱全切的患者。随着T分期的增高,患者生存期逐渐减短;盆腔淋巴结转移的4例患者分别于术后8、10、11、18个月死亡,而未发现淋巴结转移的患者中有6例存活至少2年或以上,最长者目前随访75个月仍生存;不同肿瘤分级患者生存期无明显差异。部分患者接受放化疗等辅助治疗,但对患者预后改善不明显。结论:膀胱鳞癌预后差,早期诊断很重要,应尽早行根治性膀胱全切+盆腔淋巴结清扫术以改善患者预后,放化疗在膀胱鳞癌治疗中的作用仍需进一步探讨。
Objective：To observe the pathogensis, diagnosis, treatment and survival of the Nonbilharzial squa- mous cell carcinoma of the bladder. Method：The clinical data of 21 cases of nobilharzial squamous cell carcinoma of the bladder from April 2006 to April 2011 of our hospital were reviewed. Result： Among the 21 cases of bladder squamous cell carcinoma, 16 patients were male and 5 were female, with a mean age of 62.8 years. Haematuria was the main clinical presentation,and irritative bladder symptoms and urinary tract infection were also seen in these patients. The 1,2 and 5-year survival rates for all patients were 55%,30% and 5% respectively,and the median survival time was 16. 1 months. None of 21 patients had a superficial tumor（T1 ） ,4 patients had lymphnode metas- tases,and there is only one patient had distant metastase. Radical cystectomy could provide higher survival for pa- tients than other therapies. Some patients were submitted to adjuvant chemotherapy and radiotherapy without any significant response. Evidence was provided that.tumor stage and lymphnode status are the independent variables which affect survival probability. Conclusion： The prognosis of squamous cell carcinoma of bladder is relatively poor. It is very important for the patients to be early diagnosed and early treated. Radical cystectomy remains the mainstay of therapy for squamous cell carcinoma of the bladder. Locoregional recurrence is the primary cause of death in the majority of patients. Extensive surgery is recommended. And the role for neoadjuvant therapy needs further study.
出处
《临床泌尿外科杂志》
2013年第2期123-127,共5页
Journal of Clinical Urology
关键词
膀胱肿瘤
鳞状细胞癌
治疗
预后
bladder neoplasm
squamous cell carcinoma
treatment
pronogosis
