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目的探讨保留前列腺的根治性膀胱切除术治疗肌层浸润性膀胱癌的适应症.方法收集2013年5月至2014年12月,在昆明医科大学第二附属医院接受根治性膀胱切除术的99例男性肌层浸润性膀胱癌患者的病理资料.对术后的膀胱、前列腺标本进行系统病理切片检查,并对膀胱癌侵犯前列腺的危险因素进行统计分析.结果 99例肌层浸润性膀胱癌患者中,13例前列腺侵犯.统计分析发现膀胱肿瘤部位、膀胱颈部切缘、肿瘤分级、肿瘤分期、淋巴阳性等指标有统计学意义(P<0.05),而年龄、肿瘤大小、肿瘤数目则无统计学意义(P>0.05).结论保留前列腺的根治性膀胱切除术适用于50岁以下有保留性功能意愿的T3期以下无淋巴结转移且肿瘤未侵犯前列腺的患者.
Objective To investigate the indications of radical cystectomy for the treatment of myometrial invasive bladder cancer.Methods 99 cases of radical cystectomy undergoing radical cystectomy in the Second Affiliated Hospital of Kunming Medical University from May 2013 to December 2014 were enrolled in this study. Male myasthenic invasive bladder cancer patients with pathological data of the postoperative bladder, prostate specimens for pathological biopsy and bladder cancer risk factors for prostate invasion were statistically analyzed.Results 99 cases of myometrial invasive bladder cancer patients , 13 cases of prostate invasion.Statistical analysis showed that there were significant differences in the tumor location of the bladder, the margin of the bladder neck, the tumor grade, the stage of the tumor and the lymphoproliferative index (P <0.05), but there was no statistical significance in age, tumor size and tumor number (P> 0.05) .Conclusion Radical cystectomy with reserved prostate is suitable for patients under 50 years of age with T3 without retention of lymph node metastasis and noninvasive invasion of the prostate.