中国血液净化

›› 2003, Vol. 2 ›› Issue (9): 482-484.

• 论著 • 上一篇    下一篇

长期血液透析患者合并尿路上皮恶性肿瘤（附14例报告）

刘乃波 卞维静 方自林 谭一伟 于 力 张 凌 张 钊 姜永金   

  1. 100029 北京， 中日友好医院泌尿外科(刘乃波，方自林，谭一伟，于 力，张 钊，姜永金)，肾病中心(卞维静，张 凌)
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2003-09-19 发布日期:2003-09-19

  • Received:1900-01-01 Revised:1900-01-01 Online:2003-09-19 Published:2003-09-19

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摘要：

目的 探讨长期血液透析患者合并尿路上皮恶性肿瘤的临床表现、诊断和治疗方法。方法 回 顾性分析14例长期血液透析患者合并尿路上皮恶性肿瘤的临床资料。患者的主要临床表现为肉眼血尿伴有血块，经B超、膀胱镜、CT、MRU检查可明确诊断。12例患者行手术治疗，2例患者未行手术。其中6例膀胱全切患者采用了肾和输尿管旷置。结果 肾盂癌3例，输尿管癌1例，膀胱癌10例，其中膀胱移行细胞癌7例，鳞癌1例，腺鳞癌1例，未分化癌1例，TNM分期： T1期2例，T2期3例，T3期5例，盆腔淋巴结转移2例。7例移行细胞癌分级为：Ⅱ级4例，Ⅲ级3例。14例患者均获随访，随访时间8～48个月，平均23个月，死亡5例，9例存活患者均未见肿瘤复发。结论 长期血液透析患者合并尿路上皮恶性肿瘤发病率高，手术是主要治疗方法。

关键词: 血液透析, 尿路上皮, 恶性肿瘤

Abstract:

Objective To investigate the diagnosis and treatment of uroepithelial malignant tumor in maintenance hem dialysis patients. Methods Fourteen maintenance hemodialysis patients with uroepithelial malignant tumor from 1997 to 2002 were studied retrospectively. The primary symptom was gross hematuria with blood clot.The exact diagnosis was made by B-Ultrasound, Cystoscopy, CT and MRU examination. Results This group includes 3 cases with carcinoma of renal pelvis, 1case with carcinoma of urethra, 10 cases with bladder carcinoma. There were 7cases of bladder transitional cell carcinoma；1case of squamous cell carcinoma,1 case of adeno-squamous carcinoma, 1 case of undifferentiated carcinoma. TNM stage：T1, 2cases；T2, 3cases；T3, 5 cases. The grading in transitional cell carcinoma ：stageⅡ, 4 cases ；stage Ⅲ, 3 cases. All patients have been followed up for 8～48 months with mean 23 months, 5 of them were died. Conclusions The incidence of uroepithelial cell carcinoma was high in maintenance hemodialysis patients, and operation is the main treatment.

Key words: Uroepithelial cell, Malignant tumor