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目的探讨伴有印戒细胞癌的膀胱原发性非脐尿管型腺癌的临床及病理特点。方法回顾性分析11例伴有印戒细胞癌的膀胱原发性非脐尿管型腺癌患者的临床资料。结果 11例中,临床表现为无痛性肉眼血尿10例,膀胱刺激症状4例,排尿困难1例。均经病理诊断为伴有印戒细胞癌的膀胱原发性非脐尿管型腺癌。TNM分期Ⅰ期2例,Ⅱ期6例,Ⅲ期1例,Ⅳ期2例。行根治性膀胱全切加尿流改道术4例,行膀胱部分切除术4例,行经尿道膀胱肿瘤切除术3例。2例术后实施化疗和放疗,其他行膀胱灌注治疗。4例患者有复发和转移。随访5个月~8年,2例术后1年内死亡,9例生存1年以上。结论伴有印戒细胞癌的膀胱原发性非脐尿管型腺癌少见,预后差。早期诊断、选择合适的手术方式及术后辅助放化疗有益于改善患者的预后。
Objective To investigate the clinical and pathological features of primary non-urachal adenocarcinoma of the bladder associated with signet ring cell carcinoma. Methods The clinical data of 11 patients with signet-ring cell carcinoma of primary cystadenocarcinoma without bladder cancer were retrospectively analyzed. Results In 11 cases, the clinical manifestations were painless gross hematuria in 10 cases, bladder irritation in 4 cases and dysuria in 1 case. Pathologically diagnosed with signet ring cell carcinoma of the bladder primary non-urachal adenocarcinoma. TNM stage Ⅰ in 2 cases, Ⅱ in 6 cases, Ⅲ in 1 case, Ⅳ in 2 cases. 4 cases of radical cystectomy plus urinary diversion, 4 cases of partial cystectomy, 3 cases of transurethral resection of the bladder tumor. Two patients underwent chemotherapy and radiotherapy and the other patients received bladder irrigation. Four patients had recurrence and metastasis. Followed up for 5 months to 8 years, 2 patients died within 1 year after operation, and 9 patients survived for more than 1 year. Conclusions Primary non-urachal adenocarcinoma of the bladder with signet-ring cell carcinoma is rare with poor prognosis. Early diagnosis, select the appropriate surgical methods and adjuvant radiotherapy and chemotherapy is beneficial to improve the prognosis of patients.