Kajita Y, Habuchi T, Kamoto T, Okuno H, Terai A, Kakehi Y, Terachi T, Ogawa O, Yoshida O
Department of Urology, Kyoto University School of Medicine.
Hinyokika Kiyo. 2000 Oct;46(10):711-4.
Five cases of urachal carcinoma experienced in our hospital during the past 20 years are reported. Surgical resection is considered as the first treatment option of this disease, and other therapies to be less beneficial. Complete surgical extirpation and detection of recurrence in the early stage are considered to be important since local recurrence occurs frequently. We enforced the bladder preserving operation for 4 patients with urachal carcinoma except for 1 case with peritonitis carcinomatosa in the initial diagnosis, and multiple surgical treatment was performed again for 2 patients with recurrence. The bladder was preserved with no evidence of malignancy in three patients for 24, 19 and 5 years, respectively. In the initial management of urachal carcinoma, we believe that bladder-preserving surgery should be considered in selected cases though close follow-up is demanded. Herein, we also report the immunohistochemical study of paraffin-embedded specimens using anti-CEA, CA19-9, CA125 and p53 monoclonal antibodies. The positive reaction was observed in 100% (5/5) for CEA, 80% (4/5) for CA19-9, and 20% (1/5) for CA125. These results suggest that CEA may be a useful marker in the diagnosis of this neoplasm and early detection of its recurrence. Nuclear accumulation of p53 was observed in 80% (4/5), but it did not correlate with the disease progression.
报告了我院在过去20年中收治的5例脐尿管癌病例。手术切除被认为是该疾病的首选治疗方法，而其他治疗方法的益处较小。由于局部复发频繁发生，完整的手术切除和早期复发检测被认为很重要。除1例初诊时伴有癌性腹膜炎的患者外，我们对4例脐尿管癌患者实施了保膀胱手术，对2例复发患者再次进行了多次手术治疗。3例患者分别在术后24年、19年和5年时膀胱得以保留，且无恶性肿瘤迹象。在脐尿管癌的初始治疗中，我们认为尽管需要密切随访，但在某些特定病例中应考虑保膀胱手术。在此，我们还报告了使用抗CEA、CA19-9、CA125和p53单克隆抗体对石蜡包埋标本进行的免疫组化研究。CEA的阳性反应率为100%（5/5），CA19-9为80%（4/5），CA125为20%（1/5）。这些结果表明，CEA可能是诊断这种肿瘤及其早期复发检测的有用标志物。80%（4/5）的病例观察到p53核积聚，但它与疾病进展无关。
