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目的 探讨原发性输尿管癌的诊断方法和治疗效果 .方法 回顾性分析近 12 a来收治的 36例原发性输尿管癌 .术前行尿脱落细胞学检查、B超检查、CT扫描、静脉尿路造影、膀胱镜检查及逆行尿路造影 . 30例行患侧肾输尿管和膀胱袖状切除术 ,其余 6例行其他手术方式 ,术后均行膀胱内灌注化疗 ,获随访 33例 .结果 尿脱落细胞阳性率为 5 2 .4% ,B超检查及 CT扫描阳性率分别为 71.0 %和 93.1% ,36例术后病理检查结果均为移行细胞癌 ,13例术后再发膀胱癌 .结论 尿脱落细胞学检查简便低廉、是较好的定性诊断方法 ,CT扫描是重要的定位诊断方法 ,各种检查方法有相互补充的作用 .肾、输尿管和膀胱袖状切除术是主要的治疗方法 .患者的预后与肿瘤部位、临床分期、病理分级及 DNA的倍体类型相关
Objective To investigate the diagnosis and treatment effect of primary ureteral carcinoma.Methods Thirty-six cases of primary ureteral carcinoma admitted in the past 12 years were retrospectively studied.All patients underwent exfoliative cytology, B-ultrasound, CT scan, Cystoscopy and retrograde urography.30 cases of ipsilateral renal ureter and bladder sleeve resection, and the remaining 6 cases underwent other surgical methods, after intravesical chemotherapy, were followed up for 33 cases.Results Urine The positive rate of exfoliated cells was 52.2%, the positive rates of B-ultrasound and CT scan were 71.0% and 93.1%, respectively. The pathological results of 36 cases were both transitional cell carcinoma and 13 cases of recurrent bladder cancer after operation. Urine cytology is simple and inexpensive, and it is a good method of qualitative diagnosis. CT scan is an important method of localization and diagnosis, and various examinations have complementary effects. Kidney, ureter and bladder sleeve resection are the main treatment methods. The prognosis of patients is related to tumor location, clinical stage, pathological grade and DNA ploidy type