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相關文獻
- Urological Malignancy in Chronic Dialysis Patients
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頁籤選單縮合
題名 | Urological Malignancy in Chronic Dialysis Patients=慢性透析病患的泌尿道惡性腫瘤 |
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作者 | 莊仲華; 李建德; 蔡崇麟; 陳靖博; 許國泰; 謝輝和; Chuang, Chung-hua; Lee, Chien-te; Tsai, Tsung-lin; Chen, Jin-bor; Hsu, Kuo-tai; Hsieh, Hwei-ho; |
期刊 | 臺灣腎臟醫學會雜誌 |
出版日期 | 20020300 |
卷期 | 16:1 2002.03[民91.03] |
頁次 | 頁19-24+51 |
分類號 | 415.816 |
語文 | eng |
關鍵詞 | 泌尿道惡性腫瘤; 末期腎病; 透析療法; Malignancy; Uremia; Dialysis; Transitional cell carcinoma; |
中文摘要 | 慢性腎衰竭病人在接受長期透析治療後,有比常人更高的癌症發生率,特別是泌尿道方面的癌症。本研究的目的,在分析本院透析病患中,泌尿道癌症的發生率及臨床特性。從1986年1月至2001年12月,共有7,503個慢性腎衰竭病人在本院接受透析治療,其中63位病患發生了泌尿道方面的癌症,包括20位男性及43位女性,以女性為主。其中61位病人接受血液透析,2位病人接受腹膜透析治療,發生率為0.84%,較常人為高。他們的平均年齡為60.9±11.0(29到85)歲,平均接受透析的時間為36.2±34.0(2到144)月。最常見的原發腎病變是慢性腎絲球腎炎。其中有57位病患病理切片報告是移形細胞癌(transitional cell carcinoma)(90.5%),而大部分移形細胞癌的病患(45.6%)在發現時是多發部位之侵犯,其他包括三個是腎細胞癌(renal cell carcinoma),一個是橫紋肌肉癌,一個是鱗狀細胞癌,而一位則是同時發生了腎細胞癌及移形細胞癌。在平均28.7±25.7個月的追蹤中,有20位病人的癌症復發,他們都是移形細胞癌的病患,在存活率方面,有35位病人存活,24位病人死亡,而4位病人失去聯絡無法追蹤。血尿是這些泌尿道腫瘤患者最常見的臨床表現,而腎盂積水則是最常合併的影像表現。我們的結論認為:移形細胞癌是我們透析病人中最常發生的泌尿道癌症,且大部分的癌症都是在進入透析的早期即發生,血尿是臨床最主要的表現且須視為是癌症發生的早期徵候而需及早作進一步之探查。 |
英文摘要 | A retrospective study was conducted in order to investigate the clinical features of urological malignancy among dialysis patients. During a study period of 16 years, 63 patients (20 males and 43 females) revealed urological malignancies, these were derived from 7,503 uremic patients, constituting an incidence of 0.84%. The mean age of this group of 63 patients was 60.9±11.0 (29~85) years, and their mean duration of dialysis was 36.2±34.0 (2~144) months. Chronic glomerulonephritis was the most common underlying renal disease. Gross hematuria was the most common presenting symptom (92.1%) and hydronephrosis was the most commonly associated image finding. The categories of malignancy included transitional cell carcinoma (TCC; 57/63), renal cell carcinoma (RCC; 3/63), rhabdomyosarcoma (1/63), squamous cell carcinoma (1/63), and concurrent TCC and RCC (1/63). Over a mean follow-up period of 28.6±25.7 months, 59.3% patients survived, with four patients being lost to follow up. Twenty patients suffered a recurrent tumor, all of whom were, originally, TCC patients (37.0%). We conclude that TCC is the most common urological malignancy among chronic dialysis patients. Most of those patients who developed cancers did so during the early period of their commencing dialysis, subsequent to presentation of with gross hematuria. We emphasize that the early detection of malignancy is of crucial importance for chronic dialysis patients. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。