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目的:探讨肾实质浸润型尿路上皮癌的临床特点。方法:回顾性分析自2011年12月~2015年5月收治14例肾实质浸润型肾盂癌患者的临床资料,讨论肾实质浸润型尿路上皮癌的特点,并对患者进行随访。结果:14例患者中9例术前确诊肾盂肿瘤,3例误诊为肾实质肿瘤,1例误诊为黄色肉芽肿性肾盂肾炎,1例在根治性膀胱全切手术中发现输尿管原位癌,术后病理证实有肾实质浸润型肾盂癌。13例患者接受手术治疗,术后病理高级别尿路上皮癌12例,其中1例伴鳞状分化,低级别尿路上皮癌1例,1例放弃手术。随访时间5~47个月,其中9例因肿瘤进展死亡。结论:肾实质浸润型尿路上皮癌影像学表现不典型,易被误诊为肾实质肿瘤或炎症,不能除外肾盂癌时,应结合术中冷冻病理检查结果决定手术方式。该病恶性程度高,预后差。
Objective: To investigate the clinical features of renal parenchymal invasive urothelial carcinoma. Methods: The clinical data of 14 patients with renal parenchymatous renal pelvic carcinoma admitted from December 2011 to May 2015 were retrospectively analyzed. The characteristics of renal parenchymal invasive urothelial carcinoma were discussed and the patients were followed up. Results: Among the 14 patients, 9 cases were diagnosed with renal pelvis tumor preoperatively, 3 cases were misdiagnosed as renal parenchymal tumor, 1 case was misdiagnosed as yellow granulomatous pyelonephritis, 1 case was found ureteral carcinoma in situ in radical operation of radical bladder Posterior pathology confirmed renal parenchymal renal pelvic cancer. Thirteen patients underwent surgical treatment. There were 12 cases of pathologically high grade urothelial carcinoma after surgery, including 1 case of squamous differentiated and low grade urothelial carcinoma and 1 case of surgically ablated operation. Follow-up time was 5 to 47 months, of which 9 patients died of tumor progression. Conclusion: Renal parenchymal infiltration of urothelial carcinoma imaging atypical, easily misdiagnosed as renal parenchymal tumor or inflammation, can not except renal pelvic cancer, surgery should be combined with intraoperative frozen pathological findings determine the surgical approach. The disease is highly malignant, the prognosis is poor.