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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 investigate the etiology, diagnosis, treatment and prognosis of non-schistosomiasis bladder squamous cell carcinoma. Methods: The clinical data of 21 patients with squamous cell carcinoma of the squamous cell carcinoma confirmed by postoperative pathology were retrospectively analyzed, including their clinical symptoms, examination, treatment and prognosis, and their prognosis were analyzed statistically. Results: The main symptoms of 21 patients showed hematuria, bladder irritation, urinary tract infection and so on. The 1-year, 2-year and 5-year survival rates were 55%, 30%, and 5%, respectively, with a median survival of 16.1 months. In the first visit, there were 0 cases in T1, 4 cases found pelvic lymph node metastasis, and 1 case found lung metastasis. Patients who received radical cystectomy had significantly longer survival than patients who did not undergo radical cystectomy. With the increase of T stage, the patients’ survival time decreased. Four patients with pelvic lymph node metastasis died at 8, 10, 11 and 18 months after operation, while 6 patients with no lymph node metastasis survived at least 2 Years or more, the longest in the current 75-month follow-up still survive; different tumor grade survival was no significant difference. Some patients received adjuvant radiotherapy and chemotherapy and other adjuvant treatment, but the prognosis of patients with no significant improvement. Conclusions: The prognosis of bladder squamous cell carcinoma is poor and early diagnosis is very important. Radical CT and pelvic lymphadenectomy should be performed as early as possible to improve the prognosis of patients. The role of chemoradiotherapy in the treatment of bladder squamous cell carcinoma needs to be further explored.