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目的提高输尿管移行细胞癌的诊治水平。方法对2001年7月～2010年10月收治输尿管移行细胞癌患者,经输尿管镜检查、活检病理检查,明确诊断。结果 15例均经病理检查证实为移行细胞癌。其中Ⅰ级3例,Ⅱ级10例,Ⅲ级2例。TNM分类法,T2期4例,T3期11例,T4期1例。16例患者获得随访,随访时间6个月～10年,死亡2例。2例患者术后12个月出现膀胱肿瘤,行膀胱部分切除术。术后定期膀胱灌注化疗。结论输尿管癌的预后取决于肿瘤的浸润程度和肿瘤的分期密切相关,尤其是分期更为重要。影像学联合输尿管镜组织活检是诊断输尿管癌的最佳途径。早期发现,及时明确诊断并且选择合理的手术方式对提高输尿管癌的生存率至关重要,同时术后需施行定期膀胱内灌注化疗及密切随访。
Objective To improve the diagnosis and treatment of ureteral transitional cell carcinoma. Methods From July 2001 to October 2010, patients with ureteral transitional cell carcinoma were examined by ureteroscopy and biopsy, and definite diagnosis was made. Results 15 cases were confirmed by pathological examination as transitional cell carcinoma. There were 3 cases of grade Ⅰ, 10 cases of grade Ⅱ and 2 cases of grade Ⅲ. TNM classification, T2 in 4 cases, T3 in 11 cases, T4 in 1 case. Sixteen patients were followed up for 6 months to 10 years with 2 deaths. Two patients had bladder tumor at 12 months after operation and partial bladder resection. Regular intravesical instillation chemotherapy. Conclusion The prognosis of ureteral carcinoma depends on the degree of tumor infiltration and tumor stage is closely related, especially staging is more important. Imaging combined with ureteroscopic biopsy is the best way to diagnose ureteral carcinoma. Early detection, timely and clear diagnosis and choose a reasonable surgical approach to improve the survival rate of ureteral cancer is essential, and require regular intravesical chemotherapy and close follow-up after surgery.