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style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">原发输尿管癌为起源于输尿管黏膜上皮的恶性肿瘤，肿瘤发展可以侵犯输尿管周围的淋巴和其他组织器官。可分尿路上皮癌及非尿路上皮癌（鳞状细胞癌及腺癌等）。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">输尿管癌多见于40~70岁，其极少发生在40岁之前。我国输尿管癌的平均发病年龄为55岁，男性比女性多。输尿管癌大多数在下1\u002F3部位，占输尿管癌的75%。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>","⚕️","2026-08-03",{"key":90,"title":91,"html":92,"icon":93,"updatedAt":88},"Symptoms","症状表现","\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">输尿管癌最常见的临床病状是血尿，肉眼可见血尿或镜下血尿。镜下血尿常见于早期或分化良好的肿瘤。血块通过输尿管可发生肾绞痛，但多数为腰部钝痛或无疼痛。部分患者因肿瘤梗阻引起肾积水。少部分患者可以无任何病状而偶然发现。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（1）血尿：\u003C\u002Fstrong>最为常见，患者多为肉眼血尿，血尿常呈间歇性反复出现，有时尿中可见条索状血块。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（2）疼痛：\u003C\u002Fstrong>为腰区钝痛或绞痛。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（3）\u003C\u002Fstrong>\u003Cstrong>肿块：\u003C\u002Fstrong>多为输尿管梗阻发生肾积水而扪及包块。临床上肿瘤本身难以扪及。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">晚期患者表现为恶液质（消瘦、贫血、虚弱）。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>","📋",{"key":95,"title":96,"html":97,"icon":98,"updatedAt":88},"causes","病因分析","\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">病因尚未明了，一般认为能引起肾盂癌、膀胱癌的致癌物质，均可引起输尿管癌，输尿管癌可能与某些致癌物质有关。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>诱发因素：\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（1）吸烟：\u003C\u002Fstrong>吸烟是上尿路肿瘤最重要的可控制危险因素。研究表明，吸烟人群上尿路上皮癌的发病率是非吸烟人群的3倍。上尿路上皮癌的发病率还与吸烟量有关，长期吸烟人群（>45年）是非吸烟人群的7.2倍。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（2）职业：\u003C\u002Fstrong>目前认为，从事化工、石油、塑料制品等行业的工人，以及接触煤或焦炭、沥青的人群是输尿管癌的高危人群。苯胺染料、β-萘胺、联苯胺是重要的致癌剂，这些致癌剂所致输尿管癌的潜伏期一般为15年以上。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（3）遗传：\u003C\u002Fstrong>遗传性输尿管癌一般发病年龄较年轻，女性多见。Li-Fraumeni综合征是一种十分罕见的染色体显性遗传综合征，该综合征可出现双侧上尿路上皮癌。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（4）巴尔干肾病：\u003C\u002Fstrong>巴尔干肾病是一种退行性肾间质疾病，该病常有家族史。在某些地区，巴尔干肾病患者罹患尿路上皮癌的概率要增加100~200倍。巴尔干肾病引起的肾盂、输尿管癌多为双侧，并且癌分化较好，分级低，生长较缓慢。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（5）镇痛药：\u003C\u002Fstrong>目前的研究已经证实，滥用镇痛药（特别是非那西丁）是肾盂、输尿管癌的危险因素之一。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（6）含马兜铃酸的中草药：\u003C\u002Fstrong>含马兜铃酸的中草药，以马兜铃、关木通、广防已、青木香、天仙藤等药物中含量较高。目前研究显示，该类中草药具有显著的致癌作用，其容易引起肾盂、输尿管癌。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（7）其他：\u003C\u002Fstrong>其他危险因素，包括乌脚病、尿毒症长期透析，应用环磷酰胺，尿路感染和结石等。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>","🧬",{"key":100,"title":101,"html":102,"icon":103,"updatedAt":88},"diagnosis","诊断检查","\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>1、医生如何诊断输尿管癌？\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cul class=\" list-paddingleft-2\" style=\"list-style-type: disc;\">\u003Cli>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003C\u002Fspan>\u003Cspan style=\"text-align: justify; font-size: 15px;\">患者有明显的间歇性肉眼血尿伴条索状血块。\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp>\u003Cspan style=\"text-align: justify; font-size: 15px;\">尿脱落细胞中发现肿瘤细胞。\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp>\u003Cspan style=\"font-size: 15px; text-align: justify;\">影像学检查发现输尿管实性肿物。\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp>\u003Cspan style=\"font-size: 15px; text-align: justify;\">病理证实为输尿管癌。\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003C\u002Ful>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>2、输尿管癌有哪些检查？\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（1）尿脱落细胞检查：\u003C\u002Fstrong>诊断正确率为60%~70%，近年来，尿脱落细胞荧光原位杂交检测有效地提高了阳性率，临床逐渐得到广泛应用。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（2）膀胱镜检：\u003C\u002Fstrong>膀胱镜检常可发现患侧输尿管口喷血及观察膀胱内有无肿瘤。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（3）静脉或逆行肾盂输尿管造影：\u003C\u002Fstrong>80%的患者可发现输尿管充盈缺损、输尿管扩张及肾积水。充盈缺损不规则，病变处输尿管轮廓消失，肿瘤上方呈杯状扩张。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（4）B超检查：\u003C\u002Fstrong>直接发现输尿管肿瘤较困难。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（5）CT扫描：\u003C\u002Fstrong>早期小肿瘤难以发现，较大肿瘤CT扫描可以确诊，CT扫描还可了解肿瘤浸润的范围。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（6）输尿管镜检：\u003C\u002Fstrong>输尿管镜可直接到达肿瘤部位，观察肿瘤的形态、大小和取小块肿瘤组织送切片病理检查。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（7）手术探查：\u003C\u002Fstrong>目前很少采用，少数患者由于术前诊断困难，可行手术探查，在术中取组织快速病理切片，以明确肿瘤性质及进一步确定手术方案。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>3、输尿管癌需要和哪些疾病区别？\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（1）结石：\u003C\u002Fstrong>阴性结石位于输尿管可见到充盈缺损，这种情况也可产生输尿管及尿内细胞异型性改变，因此，它容易误诊。B超和CT平扫有助于鉴别结石和肿瘤。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（2）输尿管息肉：\u003C\u002Fstrong>输尿管息肉属于输尿管良性肿瘤，造影检查也表现为充盈缺损，但息肉的充盈缺损呈边缘光滑长条状，患者病程长，尿脱落细胞检查阴性等可资鉴别。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（3）血块：\u003C\u002Fstrong>输尿管内有血块，造影检查也可见到充盈缺损，但血块可在数日后排出或吸收，复查静脉尿路造影充盈缺损可消失或变形。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>","🩺",{"key":105,"title":106,"html":107,"icon":108,"updatedAt":88},"treatment","治疗方式","\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">标准的基本治疗方法是根治性肾输尿管全切术。切除范围包括患侧肾脏、全段输尿管以及输尿管在膀胱的开口周围部分膀胱。是否行区域性淋巴结清扫尚有争议。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">低级别低分期的原发性输尿管癌，可行经输尿管镜电灼或切除术，也可行输尿管节段切除再吻合或输尿管膀胱吻合。孤立肾或者双肾病变患者，有时候只能采取保守手术以尽可能保留肾功能。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">原发性输尿管癌化学治疗或放射治疗效果均不理想。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>输尿管癌有哪些手术治疗？\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（1）开放根治性肾输尿管全切除术：\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">其是传统的基本治疗方法。手术切除必须包括患肾、输尿管全长及输尿管开口处的膀胱壁。如果手术保留一段输尿管或其在膀胱的开口，肿瘤在残留输尿管或其开口的复发率可达33%~75%。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">开放手术的同时，医生一般均行区域淋巴结清除术。但一般认为上尿路肿瘤如果已有淋巴结转移，患者往往存在远处转移灶，淋巴结清除术是否可提高生存率存在疑问。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（2）腹腔镜根治性肾输尿管全切除术：\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">目前，输尿管肿瘤的腹腔镜辅助根治手术，可经腹腔途径或经腹膜后途径。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（3）姑息性开放手术：\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">该手术适用于需姑息性手术治疗但通过内镜不能完全切除的肿瘤。医生为了避免肿瘤扩散或种植，应选用开放手术而非腹腔镜手术。输尿管肿瘤可以根据具体情况选择姑息性输尿管肿瘤切除术。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>（4）经皮肾镜治疗：\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">该治疗适应于低分级肿瘤，且肿瘤局限，未浸润周围组织；双侧上尿路肿瘤患者；各种原因导致的无法经输尿管途径切除的近端输尿管肿瘤。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>输尿管癌有哪些化疗方案？\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">临床上常用的化疗方案，类似于膀胱癌化疗，化疗方案包括新辅助化疗和辅助化疗。目前，常用的化疗方案有GC方案和MVAC方案。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cul class=\" list-paddingleft-2\" style=\"list-style-type: disc;\">\u003Cli>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">新辅助化疗就是在确定局部性治疗\u003C\u002Fspan>\u003Cspan style=\"font-size: 15px;\">（\u003C\u002Fspan>\u003Cspan style=\"font-size: 15px;\">如手术或放疗\u003C\u002Fspan>\u003Cspan style=\"font-size: 15px;\">）\u003C\u002Fspan>\u003Cspan style=\"font-size: 15px;\">之前，采用的一种辅助性化疗。医生在术前给予新辅助化疗，可有效地缩小肿瘤体积、增加手术切除率、降低手术风险、或减少手术损伤、降低手术并发症，并且可消除或抑制可能存在的微转移灶、减少不良预后因素。术前化疗对肿瘤细胞的杀伤最为有效，肿瘤的血管床未被破坏，这可有利于化疗药物的渗入，术前化疗可使手术时肿瘤细胞活力降低，肿瘤细胞不易播散入血。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cbr\u002F>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">辅助化疗是对肿瘤晚期有转移无法手术的患者或患者肿瘤切除术后采用的化疗。\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003C\u002Ful>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">化疗的并发症包括局部反应、胃肠毒性、免疫抑制、肾毒性、肝损伤、心脏毒性、肺毒性、神经毒性、脱发等。处理措施包括严格控制化疗指征、控制给药剂量和速度、加强对症处理、及时调整化疗方案，必要时可停止化疗。\u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong> \u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>输尿管癌患者的预后如何？\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">原发输尿管癌术后生存率，与患者的TNM分期和肿瘤细胞分化的程度相关。术后5年生存率为67%，有转移者生存率低于3年。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>输尿管癌会复发吗？\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">输尿管尿路上皮癌患者，容易出现膀胱癌。可同时出现，也可以表现为输尿管癌手术后出现。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">肿瘤播散学说及多中心理论，为目前公认的UTUC术后引起膀胱肿瘤复发的学说，前者指游离的肿瘤细胞可定植在尿路上皮的任何位置而发展成为新发肿瘤；后者指整个尿路上皮受到致癌因素的影响，在基因层面失去对正常生长的调控，可在不同部位出现新发肿瘤。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>","💊",{"author":110,"reviewedBy":110,"lastReviewed":110,"datePublished":110,"citations":111,"disclaimer":110},"",[112,114,116,118,120,121,123],{"title":113},"那彦群,李鸣.泌尿外科学高级教程.北京:人民军医出版社.2011.4,168-181.",{"title":115},"叶章群.泌尿外科疾病诊疗指南.3版.北京:科学出版社,2013.6,131-133.",{"title":117},"吴阶平.吴阶平泌尿外科学.济南:山东科学技术出版社，2004.5,961-965.",{"title":119},"黄丽芳.泌尿外科疾病出院后家庭护理的风险评估及干预措施[J].中国医药指南,2012,10(15):637-638.",{"title":119},{"title":122},"周利群.中国人群上尿路尿路上皮癌新进展[J].北京大学学报(医学版),2014,46(4):504-506.",{"title":124},"U Gandhy S, Madan RA, Aragon-Ching JB. The immunotherapy revolution in genitourinarymalignancies[J]. Immunotherapy. 2020;10.2217\u002Fimt-2020-0054. doi:10.2217\u002Fimt-2020-0054.",false,1789384125773]