膀胱副神经节瘤7例报告并文献复习

doi:10.19558/j.cnki.10-1020/r.2021.02.010

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摘要 目的： 探讨膀胱副神经节瘤（PUB）的疾病特点、病理特征、诊断及治疗方法。方法： 收集2007年11月–2019年12月收治7例PUB患者的临床资料,对临床记录、手术记录、病理报告、随访记录等进行了回顾性分析。结果： 7例患者中女 6例,男1 例,术前均无排尿后高血压、心悸、排尿晕厥、血尿等临床表现;治疗方案均采取手术切除肿瘤：其中 3例行经尿道膀胱肿瘤电切（TURBT）术,4例行膀胱部分切除术。7例患者术后神经内分泌标志物嗜铬颗粒蛋白(CgA)、突触素(Syn)、CD56和S-100蛋白等免疫组化均为阳性,而上皮性标志物细胞角蛋白(CKs)、癌胚抗原（CEA）等免疫组化染色标记为阴性。术后随访11个月~12年,6例未见复发和远处转移。1 例于经尿道切除术后第5年复发,再次行经尿道切除手术。结论： PUB临床罕见,且常无明显临床症状,容易误诊。诊断主要依靠超声、CT增强扫描、膀胱镜检查及术后病理免疫组化确诊。膀胱部分切除术和TURBT术都是常用的治疗方法。建议对PUB的患者进行长期随访。

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	李彬彬
	侯国良
	刘建华
	吕晋

关键词 ：膀胱, 副神经节瘤, 免疫组化, 手术治疗

Abstract：Objective： To investigate the disease characteristics, pathological characteristics, diagnosis and treatment of paraganglioma of urinary bladder （PUB）. Methods： The clinical data of 7 PUB patients admitted to our hospital from November 2007 to December 2019 were collected. We retrospectively analyzed their clinical records, surgical records, pathological reports, and follow-up records. Results： There were 6 females and 1 male in this group. Seven patients had no clinical manifestations of post-urinary hypertension, palpitations, micturition syncope, and hematuria before operation. All were treated with surgical removal of tumor, including 4 cases of partial bladder resection and 3 cases of transurethral resection of bladder tumor （TURBT）. Seven patients had positive expression of neuroendocrine markers chromogranina （CgA）, synaptophysin （Syn）, CD56 and S-100 proteins after pathological immunohistochemical （IHC） staining, while epithelial markers such as cytokerins （CKs）, carcinoembryonic antigen （CEA） and other IHC staining markers were negative. After 11 months to 12 years of follow-up, 1 patient relapsed 5 years after TURBT and was again treated with TURBT. The remaining 6 patients had no recurrence and metastasis. Conclusion： PUB is clinically rare, often without obvious clinical symptoms, and is easily missed. Diagnosis mainly depends on ultrasound, CT enhanced scanning, cystoscopy and postoperative pathological IHC. Both partial cystectomy and TURBT are commonly used treatments. Long-term follow-up is recommended for patients with PUB.

Key words： bladder paraganglioma immunohistochemistry surgical treatment

收稿日期: 2020-06-29

基金资助:佛山市医学类科技攻关项目（2017AB001421）

通讯作者: 李彬彬,13509956768@163.com

引用本文:

李彬彬, 侯国良, 刘建华, 吕晋. 膀胱副神经节瘤7例报告并文献复习[J]. 微创泌尿外科杂志, 2021, 10(2): 123-128.
LI Binbin, HOU Guoliang, LIU Jianhua, LYU Jin. Report of 7 cases of bladder paraganglioma and literature review. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2021, 10(2): 123-128.

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