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50例膀胱增生性病变的发病机制分析

Analysis on pathogenesis of 50 cases of bladder proliferative lesions.

作者信息

Chen Zhiqiang, Lan Ruzhu, Ye Zhangqun, Yang Weimin

机构信息

Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030.

出版信息

J Huazhong Univ Sci Technolog Med Sci. 2003;23(3):294-6. doi: 10.1007/BF02829519.

Abstract

In order to study the pathogenesis, clinical and pathological characteristics of proliferative lesions of the bladder, 50 cases of proliferative lesions of the bladder from 150 patients with complaints of frequency, urgency, hematuria and dysuria were subjected to cystoscopic biopsy of the suspicious foci in the bladder. In combination with the symptoms, urine and urodynamics, the relationship of proliferative lesions of the bladder to the inflammation and obstruction of the lower urinary tract was analyzed. Of the 50 cases of proliferative bladder lesions, 44 cases (88%) had lower urinary tract infection and 29 (58%) lower urinary tract obstruction. The patients with lower urinary tract obstruction were all complicated with infection. Three cases were associated with transitional cell carcinoma. Malignant cells were detected in 1 case by urinary cytologic examination. Proliferative lesions of the bladder, especially those without other obvious mucosa changes under cystoscopy, are common histological variants of urothelium in the patients with chronic inflammation and obstruction of the lower urinary tract. Chronic inflammation and obstruction of the lower urinary tract might be the causes for proliferative lesions of the bladder. It is suggested that different treatments should be applied according to the scope and histological type of the proliferative lesions.

摘要

为研究膀胱增生性病变的发病机制、临床及病理特征,对150例有尿频、尿急、血尿及排尿困难主诉的患者中的50例膀胱增生性病变进行膀胱可疑病灶的膀胱镜活检。结合症状、尿液及尿动力学检查,分析膀胱增生性病变与下尿路炎症及梗阻的关系。50例膀胱增生性病变患者中,44例(88%)有下尿路感染,29例(58%)有下尿路梗阻。下尿路梗阻患者均合并感染。3例与移行细胞癌有关。尿细胞学检查1例发现恶性细胞。膀胱增生性病变,尤其是膀胱镜下无其他明显黏膜改变者,是下尿路慢性炎症和梗阻患者尿路上皮常见的组织学变异。下尿路慢性炎症和梗阻可能是膀胱增生性病变的病因。建议根据增生性病变的范围和组织学类型采取不同的治疗方法。

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