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1、膀胱腺癌的诊断和治疗作者：牛海涛，邱志磊，杨惠祥，张一兵，李涛，王一，孙光【关键词】膀胱肿瘤；腺癌；治疗学 Managementofadenocarcinomaofurinarybladder(reportsof29cases) ABSTRACT:ObjectiveToimprovethediagnosisaccuracyandthetreatmentofurinarybladderadenocarcinoma.MethodsOfthe29casesofurinarybladderadenocarcinoma,th
2、erearybladderadenocarcinoma,amongyandurinarydiversion,y.Ofthe9casesofurachaladenocarcinoma,6recEivedextendedpartialbladderresection,3underyandurinarydiversion.2casesofsigringcellcarcinomarecEIvedradicalcystectomyandurinarydiversion.ResultsDuringtheesrangingfrom5
3、monthsto120months.The1yearsurvivalrateeexceeded5yearsentofadenocarcinomaofurinarybladderareearlydiagnosis,differentiationofprimaryadenocarcinomaandurachaladenocarcinoma,themostsuitableoperationmethod. KEYRI的矢状位成像上，肿瘤的范围清晰可见[3]。印戒细胞癌最常见的症状为血尿，多数为非脐尿管起源[4]。原发性脐尿管
4、腺癌与继发性腺癌间的区别也很困难，仔细的检查原发性肿瘤以及周围的黏膜，结合分子生物学、免疫组织化学检查、微卫星排列、DNA倍体的测定等可能有帮助[56]。 3.2治疗原发性腺癌很难施行保留膀胱的手术，本组11例位于三角区，伴有或不伴有术前放疗的根治性膀胱切除是首选的治疗。脐尿管腺癌的治疗通常为脐尿管切除及膀胱部分切除，有学者提倡术中冰冻标本检查手术的切缘，并认为广泛的部分切除(组织学检查证实切缘阴性)可提供几乎与根治性膀胱切除一致的生存率[7]。由于考虑到局部浸润的深度和广泛的病变范围，部分学者主张采用根治性膀胱切除
5、+盆腔淋巴结清扫+脐尿管切除来治疗脐尿管腺癌[7]。腺癌通常为放化疗抵抗。本组4例复发，包括1例脐尿管腺癌，3例原发性腺癌，其中脐尿管腺癌患者获得了部分缓解，生存14个月。Aaoftheurachus:3casereportsandarevieaoftheurinarybladder[J].BrJUrol,1989,64(2):138142. [4]GrignonDJ,RoJY,AyalaAG,etal.Primarysigringcellcarcinomaoftheurinarybladder[J].AmJClin
6、Pathol,1991,95(1):1320. [5]ErdogruT,KilicaslanI,EsenT,etal.Primarysigringcellcarcinomaoftheurinarybladder.Reviearyadenocarcinomaoftheurinarybladderacasereportodalitymanagementofurachalcarcinoma:theM.D.AndersonCancerCenterexperience[J].JUrol,2003,169(4):12951298
7、. [8]AamotoM,Fukuzaaryadenocarcinomaoftheurinarybladder[J].IntJUrol,1999,6(11):581584. [9]KasaharaK,InoueK,ShuinT.Advancedadenocarcinomaoftheurinarybladdersuccessfullytreatedbythebinationofcisplatinum,mitomycinC,etoposideandtegafururacilchemotherapy[J].IntJUro
8、l,2001,8(3):133136. [10]GrignonDJ,RoJY,AyalaAG,etal.Primaryadenocarcinomaoftheurinarybladder.Aclinicopathologicanalysisof72cases[J].Cancer,1991,67(8):21652172. [11]
