CAJ | 학술논문

目的：探讨原发性膀胱神经内分泌癌( neuroendocrine carcinoma, NEC)的临床特征,以提高诊治水平。方法对原发性膀胱NEC 2例的临床和病理资料进行回顾性分析,重点就膀胱镜活检与术后病理诊断误差原因及防范措施进行讨论。结果本组2例均为男性,均表现为无痛性肉眼血尿,肿瘤均位于侧壁,例2因肿瘤体积大而广泛,侵犯前列腺并堵塞尿道内口出现排尿困难甚至尿潴留。2例膀胱镜活检均诊断为膀胱移行细胞癌,分别行经尿道膀胱肿瘤电切术(例1)、根治性膀胱全切术(例2),术后均明确诊断为原发性膀胱NEC。例1术后行全身化疗,随访9个月未见肿瘤转移,10个月后失访；例2术后6个月随访存活且未见肿瘤转移。结论原发性膀胱NEC是一种临床少见的高度恶性肿瘤,提高术前活检标本采集水平及病理检查认知度,有助于避免误诊。
목적：탐토원발성방광신경내분비암( neuroendocrine carcinoma, NEC)적림상특정,이제고진치수평。방법대원발성방광NEC 2례적림상화병리자료진행회고성분석,중점취방광경활검여술후병리진단오차원인급방범조시진행토론。결과본조2례균위남성,균표현위무통성육안혈뇨,종류균위우측벽,례2인종류체적대이엄범,침범전렬선병도새뇨도내구출현배뇨곤난심지뇨저류。2례방광경활검균진단위방광이행세포암,분별행경뇨도방광종류전절술(례1)、근치성방광전절술(례2),술후균명학진단위원발성방광NEC。례1술후행전신화료,수방9개월미견종류전이,10개월후실방；례2술후6개월수방존활차미견종류전이。결론원발성방광NEC시일충림상소견적고도악성종류,제고술전활검표본채집수평급병리검사인지도,유조우피면오진。
Objective To investigate the clinical features of primary neuroendocrine carcinoma ( NEC) of bladder to improve the level of diagnosis and treatment. Methods Clinical and pathological data of 2 cases of primary bladder NEC were retrospectively analyzed, mainly on the cystoscopy biopsy and postoperative pathological diagnosis error causes and preventive measures were discussed. Results Two male patients had painless gross hematuria and tumors were located in the lateral wall. 's the tumor volume of Case 2 was big and broad, infringement of prostate congestion urethral mouth appeared to have dysuria and urinary retention. 2 cases of cystoscopy and biopsy were diagnosed as bladder transitional cell carcinoma and tran-surethral plasmakentic vaporization of bladder tumor respectively. Case 1 underwent electricity cut method, radical bladder full cut method (Case 2), both were confirmed as primary bladder NEC. Case 1 underwent systemic chemotherapy, and a postop-erative follow-up of 9 months did not find tumor metastasis, but follow-up was lost after ten months; Case 2 survived after 6 months of follow-up and no tumor metastasis was found. Conclusion Primary bladder NEC is a clinically rare and highly ma-lignant tumor. Improvement of preoperative biopsy specimen collection and pathologic examination recognition may help to a-void misdiagnosis.