膀胱非上皮性肿瘤的临床特征及治疗

Clinical Characteristics and Treatment of Non-Epithelial Tumors of the Bladder

摘要: 目的：总结膀胱非上皮性肿瘤的临床表现及诊治流程，探讨其治疗方法与预后。方法：回顾性分析2018年1月至2022年3月就诊于青岛大学附属医院并确诊为膀胱非上皮性肿瘤的14例患者的临床资料。其中，男9例，女5例。年龄35~72岁。首发症状为无痛性肉眼血尿3例，膀胱刺激征伴排尿困难3例，肉眼血尿伴膀胱刺激征1例，尿频1例，腰痛1例，无症状者5例。超声检查发现膀胱内占位病变12例，肿物凸向腔外2例，CT发现盆腔内多发肿大淋巴结2例(病理均证实为恶性肿瘤)。结果：良性肿瘤6例，均行经尿道膀胱肿瘤电切术(Transurethral Resection of Bladder Tumor, TURBT)，4例于TURBT后行膀胱部分切除术(Partly Cystectomy, PC)；恶性肿瘤8例，均行TURBT，其中1例于术后辅以BR方案化疗，2例于术后行RC，1例于术后行膀胱旷置 + 输尿管皮肤造口，1例于术后1月进展至多发骨转移、肺转移。14例患者存活至今。结论：膀胱非上皮性肿瘤发病率低，病理类型复杂，外科手术治疗是其主要处理方式，良性肿瘤预后良好，但仍有复发风险，恶性肿瘤应结合其病理特点进行辅助放疗、化疗等治疗。

Abstract: Objective: To summarize the clinical manifestations and diagnostic and treatment processes of non-epithelial tumors of the bladder, and to explore their treatment methods and prognosis. Methods: The clinical data of 14 patients who attended the Affiliated Hospital of Qingdao University from January 2018 to March 2022 and were diagnosed with non-epithelial tumor of the bladder were retrospectively analyzed. Among them, 9 cases were male and 5 cases were female. The age range from 35~72 years old. The first symptoms were painless hematuria in 3 cases, bladder irrita-tion with dysuria in 3 cases, hematuria with bladder irritation in 1 case, urinary frequency in 1 case, lumbago in 1 case, and asymptomatic in 5 cases. Ultrasonography found intravesical space- occupy-ing lesions in 12 cases, swelling projecting out of the cavity in 2 cases, and CT found multiple en-larged lymph nodes in the pelvis in 2 cases (all of which were pathologically confirmed to be malig-nant tumors). Results: There were 6 cases of benign tumors, all of them underwent Transurethral Resection of Bladder Tumor (TURBT), 4 cases underwent Partly Cystectomy (PC) after TURBT; There were 8 cases of malignant tumors, 8 cases of malignant tumors underwent TURBT, 1 case was supplemented with postoperative chemotherapy with BR regimen, 2 cases underwent postopera-tive RC, 1 case underwent ureteral dermatostomy without PC, and 1 case had progressed to multi-ple bone and lung metastases at 1 month postoperatively. 14 patients survived to date. Conclusion: Non-epithelial tumors of the bladder have low incidence and complex pathological types, surgical treatment is the main treatment for them, benign tumors have good prognosis but still have the risk of recurrence, and malignant tumors should be treated with adjuvant radiotherapy and chem-otherapy in combination with their pathological characteristics.