膀胱微乳头型尿路上皮癌临床病理分析
| 作者: |
1杨珊珊,
2葛凤林,
3王雪迪,
3付尧
1 南京中医药大学附属中西医结合医院病理科，江苏省中医药研究院，南京 210028 2 南京市六合区人民医院病理科，南京 210028 3 南京鼓楼医院病理科，南京 210008 |
| 通讯: |
付尧
Email: yao_fu@aliyun.com |
| DOI: | 10.3978/j.issn.2095-6959.2018.10.004 |
| 基金: | 国家自然科学基金 (81502170)。 |
摘要
目的：研究具有微乳头型结构的膀胱尿路上皮癌的临床病理特征。方法：对17例根治性膀胱微乳头型尿路上皮癌的临床表现、病理学形态、免疫表型和预后进行回顾性分析。结果：发病年龄41~74(平均63.9)岁，其中男16例，女1例。临床症状主要表现为血尿。形态学肿瘤由小巢状细胞聚集形成，周围可见明显的收缩裂隙样结构。免疫组织化学E - cad及上皮膜抗原(ep ithel ial membrane antigen，EMA)可见“内外倒置”结构排列。获得随访16例，失访1例，平均随访时间为33个月，死亡7例，平均死亡时间为16个月。结论：微乳头型尿路上皮癌预后不良，微乳头型结构成分同高级别肿瘤浸润、淋巴结转移及脉管侵犯显著相关，免疫组织化学有助于诊断及鉴别诊断。
关键词：
尿路上皮癌；微乳头；临床病理学
A clinicopathologic analysis of micropapillary urothelial carcinoma of bladder
CorrespondingAuthor: FU Yao Email: yao_fu@aliyun.com
DOI: 10.3978/j.issn.2095-6959.2018.10.004
Foundation: This work was supported by the National Natural Science Foundation of China (81502170).
Abstract
Objective: To study the clinicopathologic feature of micropapillary urothelial carcinoma in bladder. Methods: The clinical data of 17 cases of micropapillary urothelial carcinoma in bladder were retrospectively analyzed, including clinical features, pathological morphology, immunophenotype and prognosis. Results: The age ranged from 41–74 (median 63.9) years, 16 males and 1 female were included. The main clinical manifestations were hematuria. Morphologically, small nests and papillae forms within back-to-back lacunar spaces. Immunoreactivity for E-cad and EMA showed the arrangement of “internal and external inversion”. Sixteen cases were followed up and 1 case was missed, the average follow-up time was 33 months. Seven cases were died and the average time of death was 16 months. Conclusion: The prognosis of micropapillary urothelial carcinoma is poor. Components of micropapillary carcinoma have significant correlation between tumor invasion, lymph node metastasis and vascular invasion. Immunohistochemistry is helpful for diagnosis and differential diagnosis.
Keywords：
urothelial carcinoma; micropapillary carcinoma; clinicopathology