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中華民國泌尿科醫學會雜誌

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篇名 Primary Adenocarcinoma of the Urinary Bladder – Clinical and Pathological analysis of 25 Cases
卷期 4:2
並列篇名 原發性膀胱腺癌-臨床、病理及預後之分析
作者 洪峻澤陳明村張國明陳光國林登龍張延驊吳宏豪徐慧興張心湜
頁次 1071-1078
關鍵字 adenocarcinomabladder neoplasmsTSCI
出刊日期 199306

中文摘要

原發性膀胱腺癌是一種十分少見的腫瘤,大約只佔所有膀胱瘤的百分之零點五到百分之二,依組織病理特徵可分為臍尿囊性及非臍尿囊性腺癌。本篇報告二十五例原發性非臍尿囊性膀胱腺癌的病理特徵及臨床經過。這二十五例腺癌中有四例含有變形細胞癌的成分,其餘二十一例則是純粹的腺癌。但這些腺癌本身在病理學上又有數種亞型:包括腺型、乳頭型、膠質型、環細胞型及明澈細胞型。原發慌膀胱腺癌可以表現單獨一種亞型或數種亞型之混合型。原發性膀胱腺癌比常見的變形細胞癌更易發生在膀胱預部及前壁,本報告有十三例(52%)發生在膀胱頂部及前壁。但腫瘤的位置及病理特徵的差異並不影響預後。和腫瘤預後最有關的因素是腺癌的分期。依A、B、C及D期的五年存活率分別是100%、28%、12%及0%具有高度的統計意義。原發性膀胱腺癌的另一特徵是復發率低,本篇僅四例(16%)有局部復發,且其中二人局部復發的病灶竟然含有變形細胞癌或表皮細胞癌的成份。遠端轉移的部位則分別是肺臟(54%),骨骼(36%)及肝臟(18%)。至於治療,則只有廣泛性或部份膀胱切除才能提供較佳的預後,放射治療或經尿道膀胱腫瘤切除只能分別提供暫緩解症狀之用。

英文摘要

Primary addenocarinoma of the urinary bladder is a rare tumor, accounting for only to 2.0%of all bladder tumors. It is divided into urachal and non-urachal tumors according to its pathogenesis. The clinical course and pathological features of 25 patients with non-urachal adenocarcinoma of the bladder were analysed retrospectively. Four cases of adenocarcinomas were admixed with transitional cell carcinoma. The remaining 21 cases were pure adenocarcinoma. However, those cases showed a single histologic pattern or combination of subtypes: glandular, papillary, colloid, signet ring cell or clear cell type. Neither the location nor the histologic appearance of the tumor was correlated with prognosis, though, the tumor stage is one of the most significant predictors for prognosis. The five-year survival rate for Stages A、B、C and D were 100%、28%、12% and 0%, respectively. Four patients (16%) had local recurrence recurrence after radical or partial cystectomy. In these four case, two recurrent tumors were composed of transitional cell carcinoma or squamous cell carcinoma. The locations of distant metastasis include lung (54%)、bone (36%) and liver (18%). It was concluded that radical or partical cystectomy cases have a better survival time than using radiotherapy or transurethral resection, which provide only the symptomatic relief.