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目的提高膀胱结石并发鳞癌的诊治水平。方法回顾分析28例膀胱结石并发膀胱鳞状细胞癌的临床资料,男19例,女9例。年龄26~68岁,平均33岁。膀胱结石病程2~18年,平均4.5年。24例行尿细胞学检查发现异形细胞19例。KUB示膀胱单发结石5例,多发结石23例,IVU提示膀胱占位性病变者11例,B超和CT示膀胱占位性病变者17例。行膀胱镜检查28例发现膀胱肿瘤21例,肿瘤大小1.2cm×1.5cm~2.2cm×5.0cm。21例行膀胱部分切除术,其中6例行输尿管膀胱移植术。7例行全膀胱切除术。结果病理报告均为膀胱鳞状细胞癌;G111例,G212例,G35例;T111例,T212例,T35例。22例获随访1~8年,平均3年,1年和5年生存率分别为63.6%(14/22)和16.7%(3/18)。结论膀胱结石并发膀胱鳞癌恶性程度高,早期诊断和手术治疗极其重要。
Objective To improve the diagnosis and treatment of bladder cancer complicated with squamous cell carcinoma. Methods A retrospective analysis of 28 cases of bladder stones complicated with squamous cell carcinoma of the bladder clinical data, 19 males and 9 females. Age 26 ~ 68 years old, average 33 years old. Bladder stones course of 2 to 18 years, an average of 4.5 years. Twenty-four cases of abnormal cells were found in 24 cases by urinary cytology. KUB showed 5 cases of single bladder calculi, multiple stones in 23 cases, IVU prompt bladder lesions in 11 cases, B ultrasound and CT showed bladder space-occupying lesions in 17 cases. Twenty-eight cases of cystoscopy were found bladder tumor in 21 cases, the tumor size of 1.2cm × 1.5cm ~ 2.2cm × 5.0cm. Twenty-one cases underwent partial bladder resection, of which 6 received ureteral bladder transplantation. Seven cases underwent total cystectomy. Results The pathological reports were all squamous cell carcinoma of bladder; G111, G212 and G35; T111, T212 and T35. Twenty-two patients were followed up for 1 to 8 years. The average 3-year, 1-year and 5-year survival rates were 63.6% (14/22) and 16.7% (3/18) respectively. Conclusion Bladder stones complicated with squamous cell carcinoma of the high degree of malignancy, early diagnosis and surgical treatment is extremely important.