腎盂與輸尿管之過渡上皮細胞癌的電腦斷層癌症分期

我們復閱台北榮總1985至89年間38例經過外科手術及病理證實為腎盂或輸尿管過渡上皮細胞癌的電腦斷層攝影，並與它們的手術發現和病理報告逐一對照。在這38個病例中，男性24人，女性14人，年齡從31至87歲，總共發現48個病灶，其中腎盂病灶19個(39.6%)；輸尿管病灶有29個(60.4%)，多發性病灶有13例(34.2%)；在電腦斷層的影像中，腎盂過渡上皮細胞癌多以浸潤性腫塊或填充性缺損于腎盂或腎盞中，1例有線條狀鈣化。輸尿管過渡上皮細胞癌則在輸尿管腔中呈現完全的軟組織密度，其中有1例則呈現新月狀的管中軟組織腫瘤。對於癌症分期，38例腎盂或輸尿管過渡上皮細胞癌中，電腦斷層攝影分期為A或B期者有28例，病理報告顯示其為A期者16例，B期者9例，D期者3例。電腦斷層攝影分期為C期者有5例，病理報告則分別為A期者2例，B期者2例，C期者只有1例。而電腦斷層攝影分期為D期者5例，均與病理的結果相符合，全部電腦斷層攝影分期的正確率為81.58%。我們相信，電腦斷層攝影對於腎盂與輸尿管過渡上皮細胞癌的癌症分期有極大的幫助，並可作為泌尿外科醫師治療計劃之根據。

關鍵字

過渡上皮細胞癌；電腦斷層攝影；癌症分期

並列摘要

Retrospective review of computed tomography (CT) of 38 patients with transitional cell carcinoma (TCC) of renal pelvis or ureter between 1985 and 1989 in VGH-Taipei for localization and staging was done to correlate with their pathology. There were 24 men and 14 women, aged from 31 to 87. There were 48 lesions found-19 renal pelvis(39.6%) and 29 ureteral TCC(60.4%) respectively. Thirteen patients (34.2%) were noted to have multiple lesions. Pelvic TCC often presented as filling defects or infiltrating mass. Ureteral TCC always showed complete intraluminal mass and caused more severe hydronephrosis. One pelvic TCC was noted to have linear calcification in its margin. One ureteral TCC presented as a crescent intraluminal soft tissue mass. As the correlation between CT and pathologic staging, 28 cases staged 'A or B' by CT were staged by pathology as A in 16 cases, B in 9 cases, and D in 3 cases respectively. Only one in 5 cases staged C by CT was proved by pathology; the other 4 patients were 2 at stage-A and 2 at stage-B. All 5 CT stage-D cases were verified by pathology. The overall accuracy rate of CT staging was 81.58%. We believe that CT staging in TCC of renal pelvis and ureter is helpful in the treatment planning, especially in stage-A, stage-B and stage-D cases.

並列關鍵字

transitional cell carcinoma ； computed tomography ； staging

國際替代計量

腎盂與輸尿管之過渡上皮細胞癌的電腦斷層癌症分期

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