CAJ | 학술논문

目的探讨尿路上皮内翻性乳头状瘤的临床表现、生物学行为及临床诊治方案.方法回顾性分析1990年1月至2008年8月62例尿路上皮内翻性乳头状瘤患者的临床资料.男性51例,女性11例,平均年龄56.4岁.单发56例,多发6例.肉眼血尿为最常见的首发临床表现.发病部位在输尿管5例,4例行肿瘤局部切除术,1例行左肾及输尿管全长切除术;发生于输尿管合并膀胱1例,行膀胱全切术;发生于膀胱52例,44例行经尿道膀胱肿瘤切除术,6例行膀胱部分切除术,2例行膀胱全切术;发生于尿道4例,1例行经尿道肿瘤切除术,3例行尿道肿瘤切除术.结果 62例患者术后病理均证实为内翻性乳头状瘤,其中伴发尿路上皮癌7例.49例随访3个月～12年.2例分别于术后7和79个月复发,3例分别在术后18个月、2年和6年发现尿路上皮癌.结论尿路上皮内翻性乳头状瘤为良性肿瘤,需与尿路上皮恶性肿瘤相鉴别.手术是其主要治疗方式,术后应定期复查膀胱镜及随访.
목적 탐토뇨로상피내번성유두상류적림상표현、생물학행위급림상진치방안.방법 회고성분석1990년1월지2008년8월62례뇨로상피내번성유두상류환자적림상자료.남성51례,녀성11례,평균년령56.4세.단발56례,다발6례.육안혈뇨위최상견적수발림상표현.발병부위재수뇨관5례,4례행종류국부절제술,1례행좌신급수뇨관전장절제술;발생우수뇨관합병방광1례,행방광전절술;발생우방광52례,44례행경뇨도방광종류절제술,6례행방광부분절제술,2례행방광전절술;발생우뇨도4례,1례행경뇨도종류절제술,3례행뇨도종류절제술.결과 62례환자술후병리균증실위내번성유두상류,기중반발뇨로상피암7례.49례수방3개월～12년.2례분별우술후7화79개월복발,3례분별재술후18개월、2년화6년발현뇨로상피암.결론 뇨로상피내번성유두상류위량성종류,수여뇨로상피악성종류상감별.수술시기주요치료방식,술후응정기복사방광경급수방.
Objective To investigate the elinical manifestation, biological behavior, diagnosis and treatment of the urothelial inverted papilloma. Methods Sixty-two cases of urothelial inverted papilloma were analyzed retrospectively from January 1990 to August 2008. Of the 62 patients, 51 were men and 11 were women. The average age at presentation was 56. 4 years old. Fifty-six cases were solitary tumors and 6 were multiple. The most common compliant was macroscopic hematuria. The tumor located at the ureter in 5 eases. Of these cases, 4 were treated by local excision, 1 by nephrouretereetomy. One ease of multiple ureteral inverted papilloma with coexistent bladder inverted papilloma was treated by total cystectomy. The tumor located at the bladder in 52 cases, with 44 treated by transurethral resection of bladder tumor, 6 by partial eystectomy, 2 by total cystectomy. Four cases had the tumor located at the urethra, with 1 treated by transurethral resection of tumor, 3 by tumorectomy. Results The postoperative pathological diagnosis of all the 62 cases was inverted papilloma, synchronous urothelial carcinoma in 7. Follow-up data were available in 49 cases. Two cases had a recurrence at 7 months and 79 months, respectively. Three ease of subsequent transitional cell carcinoma developed 18 months, 2 years and 6 years later, respectively. Conclusions Inverted urothelial papilloma is a kind of benign tumor. It should be differentiated from malignant urothelial tumors. Surgical operation is the main treatment choice. Cystoseopie surveillance and followup are necessary after the operation regularly.