摘要
目的 探讨膀胱低恶倾向乳头状尿路上皮肿瘤 (PUNLMP)病理特点及临床治疗措施。 方法 2 1例石蜡包埋标本源于膀胱镜活检 16例 ,经尿道膀胱肿瘤切除术 (TURBT) 5例。患者男 11例 ,女 10例。平均年龄 57岁。其中伴血尿 14例 ,下尿路刺激症状 4例 ,下尿路不全梗阻 2例 ,偶然发现 1例。病理切片符合 1998年WHO/ISUPPUNLMP病理诊断标准。同期尿路上皮乳头状瘤 3例 ,Ⅰ级乳头状移行细胞癌 11例 ,Ⅱ～Ⅲ级乳头状移行细胞癌 3 8例作为对照。 结果 2 1例患者行TURBT 19例 ,膀胱部分切除术 2例。病理检查 :PUNLMP乳头的尿路上皮细胞排列规则 ,细胞核可有轻度不典型增生 ,尿路上皮可轻度增厚 ,层次可超过 7层 ,细胞核分裂相少见且仅在基底层 ,没有浸润和转移。平均随访 12个月 ,复发 1例。 结论 膀胱低恶倾向乳头状尿路上皮肿瘤具有独立的病理特点 ,以局部治疗为主 。
ObjectiveTo elucidate the clinical and p at hologic characteristics of papillary urothelial neoplasms of low malignant poten tial (PUNLMP).Methods21 paraffin-embedded blocks origi ned from 16 cystoscopic-biopsy cases and 5 TURBT cases were studied.All the his tologic slides fulfilled the diagnostic criteria of the 1998 World Health Organi zation/International Society of Urological Pathology Classification System as PU NLMP.A comparetive study of the histological difference between the PUNLMP and p apilloma (3 cases),low grade papillary urothelial carcinoma (11),high grade papi llary urothelial carcinoma (38) was conducted.All the patients have been followe d up from 7 to 15 months.Age of the patiens at diagnosis ranged from 32 to 73 ye ars (mean 57 years) and the male-to-female ratio 1.1 ∶1.0.Clinical presentati on of PUNLMP in 21 patients included hematuria 14 cases,irritative symptoms 4 ca ses,obstructive symptoms 2 cases,incidential findings 1 case.19 cases underwent TURBT and 2 partial cystectomy.ResultsAll the patiens have been well except 1 with recurrence.PUNLMP has specific pathological pattern s with an orderly arrangement of cells within papillae,minimal architectural abn ormalities and minimal nuclear atypia.The urothelium is thicker (>7 layers).Mito tic figures are infrequent and usually limited to the basal layer.C onclusionsPUNLMP is not associated with invasion or metastases and should be treated locally.However,long term clinical follow-up is warranted.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2003年第12期827-829,共3页
Chinese Journal of Urology
