5例膀胱尿路上皮癌伴肉瘤样变临床病理分析.docVIP

精品论文 参考文献 5例膀胱尿路上皮癌伴肉瘤样变临床病理分析 陈靖 权昌益 李博 常文亮 王江 牛远杰（通讯作者） （天津医科大学第二医院〈天津市泌尿外科研究所〉 300211） 【中图分类号】R739【文献标识码】A【文章编号】1672-5085（2012）2-0104-03 【摘要】目的 探讨膀胱尿路上皮癌伴肉瘤样变的病理和诊疗特点。方法 回顾性分析我院1995年至2010年收治的5例膀胱尿路上皮癌伴肉瘤样变的临床资料，并结合文献复习，分析其病理和诊疗特点。结果 5例患者中男4例，女1例，年龄40-63岁，4例因间歇性无痛全程肉眼血尿入院，1例因间歇性无痛终末肉眼血尿入院，膀胱镜均提示菜花样肿物，呈浸润性生长。3例行经尿道膀胱电切术，1例行膀胱部分切除术，1例行膀胱全切加双侧输尿管皮肤造瘘术。术中所见与膀胱癌基本相同。术后病理肿瘤均由癌细胞和似肉瘤构象的肿瘤细胞2种结构组成，病理均诊为膀胱尿路上皮癌伴肉瘤样变，免疫组化有该病较特异性的表现。术后予以不同的化疗等。结论 膀胱尿路上皮癌伴肉瘤样变在膀胱恶性肿瘤中罕见，没有特征性的临床表现，确诊主要依靠病理和免疫组化检查，治疗方法采用根治性膀胱切除术效佳，但其恶性程度高，预后不良，诊断和治疗需要进一步的探索。 【关键词】膀胱肿瘤 尿路上皮癌伴肉瘤样变 临床病理 5 cases of bladder urothelial carcinoma with sarcomatoid clinicopathologic analysis 【Abstract】 Objective To study urothelial carcinoma with sarcomatoid features of the pathology and treatment. Methods A retrospective analysis of clinical data about 5 cases of bladder cancer with sarcomatoid in our hospital from 1995 to 2010, combining with review of the literature, and the analysis of its pathology and treatment characteristics. Results 5 patients, 4 males and 1 female, aged 40-63 years old, 4 cases because of intermittent painless gross hematuria full admission, 1 patient with intermittent painless gross hematuria terminal admission, cystoscopy were prompted cauliflower mass, showing invasive growth. 3 cases transurethral resection of bladder,1 case partial cystectomy, and 1 case had bilateral ureteral bladder full Shaver and skin fistulization. Seen in patients with bladder cancer is basically the same. Pathology of tumor cells and the like by the conformation of the tumor cell sarcoma 2 composition, were diagnosed as pathological bladder urothelial carcinoma with sarcomatoid and immunohistochemistry have specific performance of this disease. Different chemotherapy were given after the surgeries. Conclusion Bladder urothelial carcinoma with sarcomatoid is a rare malignant tumor in the bladder, there is no characteristic clinical manifestations, and its diagnosis mainly depends on the pathological and immuno