摘要
目的 探讨膀胱腺癌的临床病理特点、诊断及鉴别诊断依据。方法 复习 2 5例膀胱腺癌的临床病理资料 ,采用HE染色、特殊染色及免疫组化技术进行观察分析 ,并对 14例进行了随访。结果 膀胱腺癌男性多见 ,男女之比为 2. 6∶1。组织学分型 :肠型 10例 ,非特异型 7例 ,黏液型 3例 ,印戒细胞型 2例 ,混合型 2例 ,透明细胞型 1例。其中原发性膀胱腺癌 2 2例 ,脐尿管腺癌 3例。临床分期 :T1/T2期 6例 ,T3/T4及ⅢA/ⅢC期 19例。随访 14例 ,平均 4年 ,7例死亡和转移的病例临床分期均为T3/T4期。特殊染色 84 %的肿瘤AB PAS(+)。免疫组化瘤细胞CK、EMA、Ki 6 7、CEA均 (+) ,vimentin、PSA(- )。结论 膀胱腺癌罕见 ,确立该诊断必须排除直肠、前列腺等腺癌的浸润或转移。免疫组化染色对鉴别诊断有帮助。患者预后与肿瘤分期关系密切 。
Objective To study the clinicopathologic characteristics, the diagnosis and differential diagnosis of urinary bladder adenocarcinoma. Methods The clinical and pathological data of 25 cases were reviewed. H-E, histochemical and immunohistochemical stains were performed in paraffin-embedded tissue sections and observed under a microscope. 14 patients were followed up. Results Urinary bladder adenocarcinoma occured more commonly in males than in females at a ratio of 2.6∶1. These lesions included 22 cases of primary bladder adenocarcinoma and 3 cases of urachal carcinoma. Histologically, these tumors included 10 cases of enteric (colonic) type, 7 cases of adenocarcinoma not otherwises specified (NOS), 3 cases of mucinous (colloid), 2 cases of signet ring cell, 2 cases of mixed and 1 case of clear cell carcinomas. Stages included 6 cases in T1/T2, 19 cases in T3/T4 and ⅢA/ⅢC. Follow-up results were obtained in 14 patients, the mean follow-up time of the treated patients was 4.0 years. 7 patients died or had metastases in stages T3/T4. The positive rate of AB/PAS staining was 84% in all cases. The tumor cells were also positive for CK, EMA, Ki-67 and CEA, and negative for vimentin and PSA. Conclusions Urinary bladder adenocarcinoma is a rare malignant tumor. Diagnosis of this tumor is necessary to rule out other adenocarcinomas involving the bladder either by metastasis or by direct invasion such as those arising in rectum, prostate, and other sites. Immunohistochemistry may be helpful in the differential diagnosis. Tumor stage is the most important prognostic factor for this tumor. Early diagnosis and radical therapy can improve the prognosis.
出处
《诊断病理学杂志》
CSCD
2005年第2期91-94,i004,共5页
Chinese Journal of Diagnostic Pathology
关键词
膀胱肿瘤
腺癌
临床病理
诊断
Urinary bladder
Adenocarcinoma
Clinicopathology
Diagnosis
