中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2009年
11期
17-19
,共3页
膀胱腺癌%临床病理%诊断%分析
膀胱腺癌%臨床病理%診斷%分析
방광선암%림상병리%진단%분석
Bladder adenocarcinoma%Clinicopathology%Diagnosis%Analysis
目的 探讨膀胱原发性腺癌的临床病理特征、诊断及鉴别诊断要点.方法 收集我院1983年至2007年诊治的有完整病历资料的膀胱腺癌患者16例,对其临床、辅助检查、病理组织学、特染及免疫组化特点进行观察、归纳总结分析.结果 膀胱原发性腺癌临床特点:主诉多为排尿不畅、血尿、膀胱刺激征;膀胱镜检特点:肿瘤块呈宽基底,蘑菇状,坚硬,表面有坏死或溃烂,或覆有粘液,或黏膜表面广泛糜烂出血,黏膜增厚欠平整;病理组织学管状或管状乳头状腺癌12例,粘液腺癌3例、透明细胞腺癌1例;PAS胞质紫红染阳性6例,免疫组化:CK7阳性11例,CK18阳性、CK19阳性、CK20阳性9例(CK7+/CK20-者6例、CK7+/CK20+者5例),CA19-9阳性者15例,CDX2者11例,P504S及β-Catenin全部阴性.结论 临床特点与膀胱结石、膀胱炎相似,膀胱镜检可见肿块及肿块表面糜烂、出血、坏死,组织学特点多与结直肠腺癌极相似,免疫组化对鉴别膀胱原发还是继发腺癌很有帮助意义.
目的 探討膀胱原髮性腺癌的臨床病理特徵、診斷及鑒彆診斷要點.方法 收集我院1983年至2007年診治的有完整病歷資料的膀胱腺癌患者16例,對其臨床、輔助檢查、病理組織學、特染及免疫組化特點進行觀察、歸納總結分析.結果 膀胱原髮性腺癌臨床特點:主訴多為排尿不暢、血尿、膀胱刺激徵;膀胱鏡檢特點:腫瘤塊呈寬基底,蘑菇狀,堅硬,錶麵有壞死或潰爛,或覆有粘液,或黏膜錶麵廣汎糜爛齣血,黏膜增厚欠平整;病理組織學管狀或管狀乳頭狀腺癌12例,粘液腺癌3例、透明細胞腺癌1例;PAS胞質紫紅染暘性6例,免疫組化:CK7暘性11例,CK18暘性、CK19暘性、CK20暘性9例(CK7+/CK20-者6例、CK7+/CK20+者5例),CA19-9暘性者15例,CDX2者11例,P504S及β-Catenin全部陰性.結論 臨床特點與膀胱結石、膀胱炎相似,膀胱鏡檢可見腫塊及腫塊錶麵糜爛、齣血、壞死,組織學特點多與結直腸腺癌極相似,免疫組化對鑒彆膀胱原髮還是繼髮腺癌很有幫助意義.
목적 탐토방광원발성선암적림상병리특정、진단급감별진단요점.방법 수집아원1983년지2007년진치적유완정병력자료적방광선암환자16례,대기림상、보조검사、병리조직학、특염급면역조화특점진행관찰、귀납총결분석.결과 방광원발성선암림상특점:주소다위배뇨불창、혈뇨、방광자격정;방광경검특점:종류괴정관기저,마고상,견경,표면유배사혹궤란,혹복유점액,혹점막표면엄범미란출혈,점막증후흠평정;병리조직학관상혹관상유두상선암12례,점액선암3례、투명세포선암1례;PAS포질자홍염양성6례,면역조화:CK7양성11례,CK18양성、CK19양성、CK20양성9례(CK7+/CK20-자6례、CK7+/CK20+자5례),CA19-9양성자15례,CDX2자11례,P504S급β-Catenin전부음성.결론 림상특점여방광결석、방광염상사,방광경검가견종괴급종괴표면미란、출혈、배사,조직학특점다여결직장선암겁상사,면역조화대감별방광원발환시계발선암흔유방조의의.
Objective To implore the clinicopathologic characters,the diagnostic and differential diagnostic main points of the bladder adenocarcinoma.Methods The 16 patients with bladder adenocarcinoma which diagnosed and treated from 1983 to 2007 were collected with integrity case history data,and their features of clinic,auxiliary examination,pathohistology,histochemical and immunohistochemieal were all summarized and analyzed.Results The clinical complains were characterized by dysuresia,hematuria,urinary frequency and urgency;the tumors cystoscope were characterized by as mushrooms shape with wide basal body,solid,ulceration or necrosis on the surface,covered with mucosal fluid,or erosion and hemorrhage extensively and thickening unsmoothly in the mucosa surface.Twelve patients were tubiform or tubiform-papillary adenocarcinomas,3 csases were mucinous adenocarcinoma and another was clear cell adenocarcinoma;6 cases were positive to PAS stain as purple in cytoplasm.The immunohistochemical stain positive were 11 cases to CK7,9 to CK20(as the CK7 +/CK20-profile 6 patients and CK7 +/CK20 + 5 cases)and all to CK18,CK19,15 to CA19-9,11 to CDX2,at the same time,all patients were negative to P504S and 13-Catenin.Conclusions The clinical findings of bladder adenocarcinoma are similar to the cystolith and cystitis,the tumors and their surface with erosion,hemorrhage and necrosis could be seen through cystoscopy,and the history features are mainly similar to colorectal adenocarcinoma.It is very helpful of differential diagnosis primary bladder adenocarcinoma from secondary by immunohistochemical stain.
