【摘要】 目的描述并分析通过外科手术治疗后上尿路上皮癌患者的临床病理特征及其合并膀胱癌的情况。方法回顾性分析本院2001年1月至2007年12月收治的26例上尿路上皮癌患者,统计分析参数包括:患者年龄、性别、临床表现、诊断方法、原发肿瘤部位(肾盂或肾盏)、肿瘤分级和分期、是否伴发膀胱癌、有无泌尿道外器官转移等。结果男性患者占57%,无痛性肉眼血尿是最常见的临床症状,大多是非浸润性(54%)和低级别(62%)肿瘤,其中1例在上尿路上皮癌发生前1个月伴有膀胱癌,2例在确诊时伴有膀胱癌,4例在手术后8~36个月发生膀胱癌(平均术后16个月),1例肾盂癌发生双肺转移。结论上尿路上皮癌容易合并膀胱癌,所有患者在外科根治手术后需要一个严格的临床随访期,浸润性高级别的肿瘤可以发生远处转移。更多还原

【Abstract】 Objective To describe the clinicopathological characteristics of patients with upper tract urothelial carcinomas who are treated surgically and to analyze the occurrence of bladder tumors.Methods The study comprised a retrospective analysis of 26 patients treated from January 2001 to December 2007.The variable analysis includs patients′ age,gender,and clinical presentation;diagnostic methods;pathologic characteristics at the primary site of the tumor(pelvis or ureter);tumor stage,grade and metastasis.Results 57 percent of patients were male,and macroscopic hematuria was the most common clinical presentation.The majority of cases(54%) were non-invasive(Ta-T1) and low-grade(62%) tumors.Synchronous or metachronous bladder tumors were found in seven of the cases.One patient had a history of bladder tumor before the diagnosis of upper tract urothelial carcinomas.Two patients were found to have bladder tumors at the time of upper tract urothelial carcinomas diagnosis.Four patients developed bladder tumors.The average period of time for diagnosis of bladder tumor was 16 months(8 to 36 months).One patient presented disease recurrence outside the urinary tract.Conclusion The presence of metachronous bladder tumors is more often observed after the diagnosis of upper tract urothelial carcinomas.All of these patients should undergo rigorous follow-up during the postoperative period.Only patients with infiltrative and high-grade tumors developed metastases outside the urinary tract.更多还原