CAJ | 학술논문

目的：总结脐尿管癌的临床特征,提高对脐尿管癌的诊治水平。方法回顾性分析36例脐尿管癌的临床资料。结果男26例,女10例。平均年龄(50.0±2.5)岁。肉眼血尿31例,血尿伴尿频、尿急5例,血尿中位时间22 d。尿中有黏液者16例。肿瘤直径平均(5.0±1.0)cm。盆腔淋巴结转移3例。TNM 分期：T221例,T312例,T43例。临床分级：G118例,G213例,G35例。均行扩大性膀胱部分切除术。术后病理诊断黏液性腺癌28例,非黏液腺癌混合癌5例(含肠型、印戒细胞亚型),乳头状腺癌3例。术后膀胱内灌注表阿霉素治疗25例。36例患者均获随访,随访1~8年,平均2.5年。术后1年生存率为50%(18/36),5年生存率为19.44%(7/36)。T2期患者的5年生存率为23.81%(5/21),T3期患者的5年生存率为16.67%(2/12)。结论脐尿管癌不容易被早期发现和诊断。血尿是脐尿管癌的最常见症状。扩大性膀胱切除术为标准手术方式。脐尿管癌预后较差。
목적：총결제뇨관암적림상특정,제고대제뇨관암적진치수평。방법회고성분석36례제뇨관암적림상자료。결과남26례,녀10례。평균년령(50.0±2.5)세。육안혈뇨31례,혈뇨반뇨빈、뇨급5례,혈뇨중위시간22 d。뇨중유점액자16례。종류직경평균(5.0±1.0)cm。분강림파결전이3례。TNM 분기：T221례,T312례,T43례。림상분급：G118례,G213례,G35례。균행확대성방광부분절제술。술후병리진단점액성선암28례,비점액선암혼합암5례(함장형、인계세포아형),유두상선암3례。술후방광내관주표아매소치료25례。36례환자균획수방,수방1~8년,평균2.5년。술후1년생존솔위50%(18/36),5년생존솔위19.44%(7/36)。T2기환자적5년생존솔위23.81%(5/21),T3기환자적5년생존솔위16.67%(2/12)。결론제뇨관암불용역피조기발현화진단。혈뇨시제뇨관암적최상견증상。확대성방광절제술위표준수술방식。제뇨관암예후교차。
Objective Summary the clinical features of urachal cancer to improve the level of diagnosis and treatment. Methods Clinical data of 36 patients with urachal cancer were retrospec-tively reviewed. Results Male 26 cases,female 10 cases.Average age was(50.0±2.5)years old. 31 cases had naked-eye hematuria,5 cases had hematuria with urinary frequency-urgency,median numbers of hematuria time was 3.5 months.1 6 cases had mucilage in urine.Average diameter of tumor was (5.0 ± 1.0)cm.3 cases had pelvic lymph node shift.TNM installments:21 cases had stage T2 ,12 had stage T3 and 3 had T4 .Clinical classification:18 cases had G1 ,13 had G2 and 5 had G3 .All cases were given expand-bladder-partial-nephrectomy.Pathological diagnosis after surgery:Mucinous adenocarcinoma was 28 cases,non-mucinous adenocarcinoma was 5 cases (intestinal and signet ring cell subtypes)and papillary adenocarcinoma was 3 cases.25 cases had intravesical chemo-therapy with epirubicin after surgery.Follow-up 36 cases,follow-up time was 1-8 years,average time was 2.5 years.One-year survival rate after surgery was 50%(18/36),five-years survival rate was 1 9.44%(7/36).Five-years survival rate of T2 was 23.81%(5/21 ),five-years survival rate of T3 was 1 6.67%(2/12). Conclusions Early diagnosis is difficult for urachal cancer.Hematuria is the most common symptom.Expand-bladder-partial-nephrectomy is standard surgical way.Progno-sis of urachal cancer is relatively poor.