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目的:探讨不同部位原发性输尿管癌与淋巴结转移的关系,并对其预后进行分析。方法:对44例原发性输尿管癌患者的肿瘤及淋巴结标本进行病理学分析,对照输尿管肿瘤的位置,并对患者的预后进行随访。结果:44例原发性输尿管癌,16例发现有淋巴结转移癌,转移率为36.4%;其中输尿管上段癌23例,淋巴结转移癌5例,转移率为22.0%;输尿管下段癌21例,淋巴结转移癌11例,转移率52.0%,二者比较差异有统计学意义(P<0.05);随访6个月~10年,死亡9例(20.5%),局部复发或远处转移16例(36.4%),肿瘤进展率为56.8%;其中输尿管上段癌进展9例,肿瘤进展率36.0%,输尿管下段癌进展16例,肿瘤进展率64.0%,二者比较差异有统计学意义(P<0.05);术后发生膀胱癌12例,发生率27.3%,其中输尿管上段癌术后出现5例,发生率41.7%,输尿管下段癌术后出现7例,发生率58.3%,二者比较差异无统计学意义(P>0.05)。结论:原发性输尿管癌淋巴结转移率较高。输尿管下段癌更易发生淋巴转移,预后也较输尿管上段癌差。
Objective: To investigate the relationship between primary ureteral carcinoma and lymph node metastasis in different parts and analyze its prognosis. Methods: Tumor and lymph node specimens of 44 patients with primary ureteral carcinoma were pathologically analyzed, the position of ureteral tumor was compared, and the prognosis of patients was followed up. Results: Twenty-four cases of primary ureteral carcinoma and 16 cases of metastatic carcinoma of the lymph nodes were found with a metastasis rate of 36.4%. Among them, 23 cases had upper ureteral carcinoma and 5 cases had lymph node metastasis with a metastasis rate of 22.0% There were 11 cases of metastatic carcinoma with metastasis rate of 52.0% (P <0.05). After 6 months to 10 years of follow-up, 9 cases (20.5%) died of local recurrence or distant metastasis %). The rate of tumor progression was 56.8%. Among them, 9 cases had advanced ureteral carcinoma, the rate of tumor progression was 36.0%, the progression of lower ureteral carcinoma was 16, and the rate of tumor progression was 64.0%. There was significant difference between them (P <0.05) ; Postoperative bladder cancer occurred in 12 cases, the incidence rate was 27.3%, of which 5 cases of upper ureteral cancer occurred after the operation, the incidence rate of 41.7%, lower ureteral cancer occurred in 7 cases, the incidence rate of 58.3%, the difference was statistically significant Significance (P> 0.05). Conclusion: Primary ureteral carcinoma has higher lymph node metastasis rate. Lower ureter cancer more likely to have lymph node metastasis, the prognosis is also worse than the upper ureter cancer.