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目的分析膀胱鳞状细胞癌(SCC)的临床特点,提高对膀胱鳞状细胞癌的认识及诊治水平。方法回顾性分析我院自1996年1月至2007年5月收治的13例该病患者的临床资料,结合国内外文献进行分析讨论。结果根治性膀胱全切膀胱替代尿流改道术7例,膀胱部分切除术4例,经尿道膀胱肿瘤电切术(TURBT)2例;1例膀胱憩室切除并输尿管再植。6例术后予以膀胱内生理盐水加OK-4325KE灌注治疗。1例术后2个月出现局部复发并盆腔广泛转移死亡;4例膀胱部分切除、1例膀胱全切除及另1例TURBT患者于术后9个月出现全身转移死亡;2例于术后12个月死于高血压心脏病;3例于术后18个月出现复发转移死亡;1例病理报告为高分化角化型鳞状细胞癌患者存活24个月,目前继续随访中。结论膀胱SCC往往呈浸润性生长,恶性程度较高,预后差。根治性膀胱全切术为其最佳治疗方法,膀胱肿瘤切除术后沙培林(OK-432)灌注治疗可适当延长其生存期,值得临床进一步研究。
Objective To analyze the clinical features of bladder squamous cell carcinoma (SCC) and to improve the understanding and diagnosis and treatment of bladder squamous cell carcinoma. Methods A retrospective analysis of our hospital from January 1996 to May 2007 were treated in 13 cases of the clinical data of patients, combined with domestic and foreign literature to analyze and discuss. Results In 7 cases of radical bladder resection with urinary diversion, 4 cases of partial resection of bladder, 2 cases of transurethral resection of bladder tumor (TURBT) and 1 case of bladder diverticulum resection and ureter replantation. Six cases were treated with intragastric saline plus OK-4325KE perfusion. One case had local recurrence and extensive pelvic metastasis and death at 2 months after operation. Four cases of partial bladder resection, one case of complete bladder resection and one case of TURBT died of systemic metastasis at 9 months after operation. Two cases died of postoperative 12 3 months died of hypertensive heart disease; 3 cases died of recurrence and metastasis 18 months after operation; 1 case of well-differentiated keratinized squamous cell carcinoma survived for 24 months and is currently under follow-up. Conclusions Bladder SCC often presents invasive growth with higher malignancy and poor prognosis. Radical mastectomy is the best treatment method. After percutaneous nephrectomy, OK-432 perfusion therapy can prolong the survival time, which is worth further clinical study.