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目的:探讨膀胱低度恶性潜能乳头状泌尿上皮肿瘤(papillary urothelial neoplasm of low malignant potential,PUNLMP)的病理和临床特征。方法:回顾性分析了2003年—2006年收治的41例病理证实为PUNLMP的病例,选取同时期收治的28例乳头状瘤和51例乳头状泌尿上皮低级别癌作为对照。结果:在41例PUNLMP中,男31例,女10例,年龄33~87岁,平均61.6岁。其中复发6例(15%),复发时间平均为24.6个月,复发后病理没有进展。在4例多发的患者中,有2例(50%)复发。在28例乳头状瘤中,复发1例(4%),复发后病理没有进展。在51例低级别癌中,复发18例(35%),5例(10%)有进展,肿瘤的复发率在这3者之间差异有统计学意义(P=0.002)。结论:PUNLMP有其独特的病理和临床特点,用“低度恶性潜能”来取代“癌”这一称谓是恰当的,由于有较高的复发率,手术后应当长期随访。
Objective: To investigate the pathological and clinical features of bladder low grade malignant papillary urothelial carcinoma (PUNLMP). Methods: A retrospective analysis of 41 cases of PUNLMP confirmed from 2003 to 2006 was performed. 28 cases of papilloma and 51 cases of low-grade papillary urothelial carcinoma were selected as control. Results: In 41 cases of PUNLMP, 31 males and 10 females, aged from 33 to 87 years, with an average of 61.6 years. Among them, 6 cases (15%) were relapsed and the average recurrence time was 24.6 months. There was no pathological change after the recurrence. Of the four patients with multiple recurrent disease, two (50%) recurred. In 28 cases of papilloma, 1 case (4%) relapsed, pathology no progress after recurrence. Among 51 low-grade cancers, 18 (35%) had recurrence and 5 (10%) had progressed. The recurrence rate of the tumor was statistically different between the three groups (P = 0.002). CONCLUSIONS: PUNLMP has its unique pathological and clinical features. It is appropriate to replace the term “cancer” with “low malignant potential”. Long-term follow-up should be performed after surgery because of its high recurrence rate.