摘要
目的：总结30余年诊治脐尿管癌的经验,探讨脐尿管癌的临床特点,提高诊治水平.方法：回顾性分析22例脐尿管癌患者的临床资料,男18例,女4例,中位年龄52岁（31~77岁）.结果：脐尿管腺癌21例,小细胞癌1例;肉眼血尿为最常见的初始症状 （20/22,90.9%）;行CT扫描16例,3例有钙化（18.75%）;膀胱镜检查18例,均发现膀胱顶部或前壁肿物;22例患者中获随访20例（90.9%）,中位随访时间28.0个月（3~184个月）,5年肿瘤特异生存率为49.5%;生存分析结果显示,T2期患者与T3期及以上患者相比生存率差异有统计学意义（P=0.026）.结论：脐尿管癌的预后与肿瘤病理分期相关;行CT和膀胱镜检查进行定位、定性诊断,扩大膀胱部分切除术是局限性脐尿管癌的主要治疗方法;对复发和转移患者积极进行综合治疗可能有助于延长其生存期.
Objective： To summarize more than thirty years of experience with urachal carcinoma and to discuss the clinical features of urachal carcinoma. Methods： The clinical data of 22 patients with urachal carcinoma, 18 males and 4 females, their median age at diagnosis was 52 years （ range ： 31 - 77 years） , were analyzed retrospectively. Results： Twenty-one cases were urachal adenocarcinoma, and 1 was small cell carcinoma. The first common symptom was gross hematuria in the urachal carcinoma patients （20/ 22, 90.9% ）, and CT showed calcification in 18.75% of them （3/16）. The cystoscopic finding was a mass seen at the dome of the bladder or anterior wall in all. Twenty cases were followed up （90.9%）, with the median follow-up 28 months （range： 3 - 184 months）. The overall 5-year cancer-specific sur- vival rate was 49.5%. It was significantly different in survival between T2 and T3 or more in the urachal carcinoma patients by survival analysis （ P = 0. 026 ）. Conclusion： The results indicate that the most im- portant predictor of prognosis is tumor stage, and it is critical for diagnosis of urachal carcinoma by CT scan and cystoscopy. Extended partial cystectomy is the main surgery of patients with urachal carcinoma. Active muhimodal treatments may improve the survival of patients with recurrent and metastatic disease.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2013年第5期774-778,共5页
Journal of Peking University:Health Sciences
