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目的提高原发性输尿管癌的诊治水平。方法回顾性分析47例经病理证实的原发性输尿管癌病例,对诊治中的若干问题进行探讨。结果肉眼血尿、腰痛和肾积水是本病三大临床表现,CT、B超和尿细胞学检查的阳性率分别为57.1%、40.9%和37.0%,42例患者分别接受了5种手术治疗,34例获得随访,5年生存率为33.3%。结论重视老年人单侧腰痛和肾积水可能早期诊断原发性输尿管癌,对不明原因的肾积水应追查其原因,老年人输尿管息肉和输尿管狭窄病变应慎重处理。
Objective To improve the diagnosis and treatment of primary ureteral cancer. Methods Retrospective analysis of 47 cases of primary ureteral carcinoma confirmed by pathology, to explore some of the problems in the diagnosis and treatment. Results Gross hematuria, low back pain and hydronephrosis were the three major clinical manifestations of the disease. The positive rates of CT, B-mode ultrasonography and urinary cytology were 57.1%, 40.9% and 37.0% respectively. Forty-two patients received five kinds of surgical treatment , 34 cases were followed up, 5-year survival rate was 33.3%. Conclusion The emphasis on unilateral low back pain and hydronephrosis in the elderly may be an early diagnosis of primary ureteral cancer, unexplained hydronephrosis should be traced back to its causes, the elderly ureteral polyps and ureteral stricture should be treated with caution.