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经尿道二次电切治疗非肌层浸润性膀胱肿瘤的意义研究 被引量：5

Significance of Second Transurethral Resection in Treating Patients with Non-Muscle Invasive Bladder Cancer
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摘要 目的探讨经尿道二次电切对治疗非肌层浸润性膀胱肿瘤的意义。方法选取首次经尿道膀胱肿瘤电切术后均诊断为非肌层浸润性尿路上皮癌患者86例,其中Ta期28例,T1期58例。术后4～6周内接受二次电切,对两次术后的肿瘤组织病理学特点进行比较。结果二次电切术后病理提示:无肿瘤者36例(41.9%);发现肿瘤残余病灶者35例(40.7%),发现肿瘤遗漏病灶者10例(11.6%);既发现残留病灶又发现遗漏病灶5例(5.8%)。首次病理Ta期患者28例,二次术后17例(60.7%)无肿瘤,6例(21.4%)病理分期与首次相同,4例(14.3%)病理分期进展至T1期,1例(3.6%)病理分期进展至T2期;首次病理T1期患者58例,二次术后19例(32.8%)无肿瘤,8例(13.8%)病理分期下降至Ta期,16例(27.6%)病理分期与首次相同,15例(25.9%)病理分期进展至T2期。Binary Logistic多元回归分析结果提示,首次电切术后肿瘤T1期、高分级、肿瘤直径>3 cm、广基形外观是影响二次术后肿瘤分期升高至T2期的独立危险因素(P<0.05)。结论经尿道膀胱肿瘤二次电切对于彻底切除肿瘤组织,明确肿瘤病理分期有相当重要的意义,从而有助于选择正确的后续治疗方案和评估预后。建议对首次术后病理提示T1期、高分级、肿瘤直径>3 cm、广基形外观的膀胱肿瘤患者进行二次电切。 Objective To explore the significance of second transurethral resection in treating patients with newly diagnosed non-muscle invasive bladder cancer（NMIBC）.Methods The research included 86 patients with stage Ta（n=28） and T1（n=58） bladder urothelial cancer.All patients underwent repeated TURBT（Re-TURBT） within 4 to 6 weeks after the initial resection.Pathologic findings of the second TURBT were compared with those of the initial one.Results Pathologic findings of Re-TURBT showed that 36（41.9%） patients were tumor-free at the second operation.Residual malignant tissues were found in 35（40.7%） patients while missed lesions were found in 10（11.6%） patients.The other 5（5.8%） patients displayed coexisted residual and missed lesions.Of the 28 Ta patients of at the first TURBT,17（60.7%） were found to be tumor-free at Re-TURBT,6（21.4%） remained in stage Ta;4（14.3%） progressed stage T1 and 1（3.6%） progressed to stage T2.Of the 58 patients of stage T1 at the first TURBT,19（32.8%） were found to be tumor-free at Re-TURBT,8（13.8%） turned stage Ta;16（27.6%） remained in stage T1 and 15（25.9%） progressed to stage T2.Binary logistic multiple regression analysis revealed that T1 stage at the first TURBT,high grade,diameters3 cm,and broadly-connected appearance were independent risk factors for progressing to stage T2 at Re-TURBT（P0.05）.Conclusion Re-TURBT is valuable for fully tumor resection and accurate staging of non-muscle invaded bladder cancer,which is required for selection of appropriate subsequent treating method and prognosis prediction.Re-TURBT is indicated for T1 staging,high grade,lager size（d3 cm）,and broadly-connected appearance.
作者 侍晓辰 陈群
机构地区 江苏省无锡市中医医院泌尿外科
出处 《中国全科医学》 CAS CSCD 北大核心 2011年第32期3708-3710,共3页 Chinese General Practice
关键词 膀胱肿瘤 膀胱切除术 肿瘤分期 Urinary bladder neoplasms Cystectomy Neoplasm staging
分类号 R737.14 [医药卫生—肿瘤]
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参考文献18

  • 1Rodrigue J, Chechil G, A lgaba F, et al. Value of random endoscopic biopsy in the diagnosis of bladder eancinoma in situ I J]. Euruol, 1987,13 (2): 150-154.
  • 2Bahjuk M, Oosterlirtck W, Sylvester R, et aL EAU guidelines on non muscle - invasive bladder urothelial cancinoma of the bladder [ J ]. U- rology, 2005, 66 (Suppl 6A) : 4 -34.
  • 3Hart KS. Results of repeated transurethral resection for a second opinion in patients referred for non muscle - invasive bladder cancer: the refemll cancer center experience and review of the literature [ J ]. Endourel,2008, 22 (12) : 2699 -2704.
  • 4Sedelaar JPM, Witjes JA. Technique of TUR of bladder tumors: value of repeat TUR and random biopsies [J]. EAU- EBU Update Series,2007, 5 (1): 139-144.
  • 5Divrik RT, Sahin AF, Yildifim, et al. Impact of rountine second tran- surethal resection on the long - term outcome of patients with newly diag- nosed pT1 urotheilal carcinoma with respect to recurrence, progression rate, and disease - specific survival: a prospective randomized clinical trial [J]. Eur Urol, 2010, 58 (2): 185-186.
  • 6Cheng L, Neumann RM, Weaver AL. Grading and staging of bladder carcinoma in transurethral resection specimens, correlation with 105 matched cystectomy specimens [J]. Clin Pathol, 2000, 113 (2): 275 - 2"/9.
  • 7Sobin DH, Witteking CH. TNM classification of malignant tumor [MI. 6thed. Wiley-liss: New York, 2002: 199-202.
  • 8Santer G, Algaba F, Amin M, et al. Tumour of urinary system: non -invasive urothelial neoplasia [ M ] // Eble JN, Sauter G, Epstein JI, Sesterhenn IA (eds). World Health Organization Classification of Tumours: Pathology and Genetics of Tumour of the Urinary System and Male Genital Organs. Lyon (France) : IARC Press, 2004: 110.
  • 9Dieter J, Herber S, Raphaela. Photodynamie diagnosis in urology: state of the art [J]. Eur Urol, 2008, 53 (6): 1138-1150.
  • 10Tritschler S, Scharf S, Karl A, et al. Validation of the diagnostic val- ue of NMP221 bladder chekl test as a marker for bladder cancer by pho- todynamic diagnosis [J]. Eur Urol, 2007, 51 (2): 403-408.

同被引文献62

  • 1Grimm M, Steinho C, Simon X.Effeet of routine repeat transurethral resection for super ficialbl add erc Kncer: a long[J].J Uwl, 2009, 170 ( 2 ) : 433-437.
  • 2Karl A,Konety BR.Treatment of superficial bladder cance[J].Evidence-based Urology,2010:304.
  • 3Han KS,Joung JY,Cho KS,et al.Results of repeated transurethral resection for a second opinion in patients referred for nonmuscle invasive bladder cancer:the referral cancer center experience and review of the literature[J].J Endourol,2008,22(12):2699-2704.
  • 4Modlich O,Prisack HB,Pitschke G,et al.Identifying superficial,muscle-invasive,and metastasizing transitional cell carcinoma of the bladder use of cDNA array analysis of gene expression profiles[J].Clinical cancer research,2004,10(10):3410-3421.
  • 5Kohrmann KU,Woeste M,Kappes J,et al.Der wert der transurethralen Nachresektion beim oberflachlichen Harnblasenkarzinom[J].Aktuelle Urologie,1994,25(4):208-213.
  • 6Vogeli TA,Grimm M,Ackermann R.Prospective study for quality control of TUR of bladder tumours by routine second TUR (reTUR)[J].J Urol,1998,159(Suppl):A543.
  • 7Grimm MO,Steinhoff C,Simon X,et al.Effect of routine repeat transurethral resection for superficial bladder cancer:a long-term observational study[J].The Journal of urology,2003,170(2):433-437.
  • 8Miladi M,Peyromaure M,Zerbib M,et al.The value of a second transurethral resection in evaluating patients with bladder tumours[J].Eur Urol,2003,43(3):241-245.
  • 9Daniltchenko DI,Riedl CR,Sachs MD,et al.Long-term benefit of 5-aminolevulinic acid fluorescence assisted transurethral resection of superficial bladder cancer:5-year Results of a prospective randomized study[J].J Urol,2005,174 (6):2129-2133.
  • 10Zurkirchen MA,Sulser T,Gaspert A,et al.Second transurethral resection of superficial transitional cell carcinoma of the bladder:a must even for experienced urologists[J].Urol Int,2004,72(2):99-102.

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二级引证文献48

中国全科医学
2011年 第32期

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