Angulo J, Escribano J, Tamayo J C, Dehaini A, Guily M, Sánchez-Chapado M
Servicio de Urología y Radiodiagnóstico, Hospital Príncipe de Asturias, Madrid, España.
Arch Esp Urol. 1997 Mar;50(2):115-20.
A clinicopathological study was conducted in patients with urothelial tumor of the bladder and urothelial neoplasm of the upper urinary tract or urethra to analyze the histological features, time interval between diagnoses and prognosis of these associated lesions.
338 patients were reviewed retrospectively. A descriptive study was performed, including tables on the associated lesions and survival data.
21 cases (6.2%) had two urothelial tumors: carcinoma of the bladder associated with tumor of the upper urinary tract (14 cases) or urethra (7 cases). There is a longer time interval between diagnoses when the extravesical tumor is diagnosed after than when it is diagnosed before the bladder tumor (p < .05). A correlation between the grade, but not stage, of the extravescial and bladder tumors has been observed. We found no statistically significant differences for survival in patients with two tumors or with bladder cancer alone. Although not statistically significant, patients with metachronous extravescial tumor have a better prognosis than those with synchronous extravesical tumor.
Patients with bladder cancer should be followed for years and screened for extravesical urothelial tumor. The foregoing associated lesion, especially the metachronous extravesical lesion, apparently does not make the prognosis worse.
对膀胱尿路上皮肿瘤以及上尿路或尿道尿路上皮肿瘤患者进行临床病理研究，以分析这些相关病变的组织学特征、诊断间隔时间及预后。
回顾性分析338例患者。进行描述性研究，包括相关病变及生存数据表格。
21例（6.2%）患者患有两种尿路上皮肿瘤：膀胱肿瘤合并上尿路肿瘤（14例）或尿道肿瘤（7例）。与膀胱肿瘤先于膀胱外肿瘤诊断相比，膀胱外肿瘤后于膀胱肿瘤诊断时，诊断间隔时间更长（p < 0.05）。已观察到膀胱外肿瘤与膀胱肿瘤的分级（而非分期）之间存在相关性。我们发现，患有两种肿瘤的患者与仅患有膀胱癌的患者在生存方面无统计学显著差异。尽管无统计学显著差异，但异时性膀胱外肿瘤患者的预后优于同时性膀胱外肿瘤患者。
膀胱癌患者应进行多年随访，并筛查膀胱外尿路上皮肿瘤。上述相关病变，尤其是异时性膀胱外病变，显然不会使预后更差。
