Background: Clear cell renal cell carcinoma (ccRCC) is the most common malignant kidney tumor in adults. Single-cell transcriptome sequencing can provide accurate gene expression data of individual cells. Integrated single-cell and bulk transcriptome data from ccRCC samples provide comprehensive information, which allows the discovery of new understandings of ccRCC and the construction of a novel prognostic model for ccRCC patients. Methods: Single-cell transcriptome sequencing data was preprocessed by using the Seurat package in R software. Principal component analysis (PCA) and the t-distributed stochastic neighbor embedding (t-SNE) algorithm were used to perform cluster classification. Two subtypes of cancer cells were identified, pseudotime trajectory analysis and gene ontology (GO) analysis were conducted with the monocle and clusterProfiler packages. Two novel cancer cell biomarkers were identified according to the single-cell sequencing and were confirmed by The Cancer Genome Atlas (TCGA) data. T cell-related marker genes according to single-cell sequencing were screened by a combination of Kaplan-Meier (KM) analysis, univariate Cox analysis, least absolute shrinkage and selection operator (Lasso) regression and multivariate Cox analysis of TCGA data. Four survival predicting genes were screened out to develop a risk score model. A nomogram consisting of the risk score and clinical information was constructed to predict the prognosis for ccRCC patients. Results: A total of 5,933 cells were included in the study after quality control. Fifteen cell clusters were classified by PCA and t-SNE algorithm. Two clusters of cancer cells with distinct differentiation status were identified. Besides, GO analysis revealed that biological processes were different between the two subgroups. Egl-9 family hypoxia-inducible factor 3 (EGLN3) and nucleolar protein 3 (NOL3) were specifically expressed in cancer cell clusters, bulk RNA sequencing data from TCGA confirmed their high expression in ccRCC tissues. GTSE1, CENPF, SMC2 and H2AFV were screened out and applied to the construction of risk score model. A nomogram was generated to predict prognosis of ccRCC by combing the risk score and clinical parameters. Conclusions: We integrated single-cell and bulk transcriptome data from ccRCC in this study. Two subtypes of ccRCC cells with different biological characteristics and two potential biomarkers of ccRCC were discovered. A novel prognostic model was constructed for clinical application.

Background Clear cell renal cell carcinoma (ccRCC) is the most common histological subtype of malignant kidney tumor. The molecular mechanism of ccRCC is complicated, and few effective prognostic predictors have been applied to clinical practice. MAX dimerization protein 3 (MXD3) is generally considered a transcription factor of the MYC/MAX/MAD transcriptional network. This study aimed to investigate the impact of MXD3 in ccRCC. Methods Gene expression profiles and clinical data of ccRCC were downloaded from The Cancer Genome Atlas (TCGA) database. MXD3 expression levels between tumors and adjacent normal tissues were compared. The influence of MXD3 on overall survival (OS) was evaluated using the Kaplan-Meier method. Associations between MXD3 expression and clinical features were assessed with the Kruskal test and Wilcoxon test. Univariate and multivariate Cox analyses were performed to observe the impact of MXD3 expression and clinical features on prognosis. The correlation between MXD3 and ccRCC immune infiltration was estimated with TIMER. The DNA methylation levels of the MXD3 promoter were obtained from UALCAN. Gene set enrichment analysis (GSEA) was conducted to explore the biological signaling pathways. Results MXD3 was overexpressed in ccRCC tumor tissues compared with adjacent normal kidney tissues. High expression of MXD3 was significantly correlated with poor prognosis. MXD3 expression levels were associated with tumor grade, tumor stage, tumor (T) classification and metastasis (M) classification. Univariate and multivariate Cox analyses showed that high expression of MXD3 was an independent risk factor for OS in ccRCC. MXD3 expression was positively correlated with the infiltrating levels of B cells and myeloid dendritic cells, and negatively correlated with macrophages. The MXD3 promoter region tended to be hypomethylated in ccRCC compared with normal tissues. GSEA identified homologous recombination, base excision repair, and glycerophospholipid metabolism as differentially enriched in ccRCC with high MXD3 expression. Conclusions This study suggests that high expression of MXD3 is an independent risk factor for poor prognosis in ccRCC. MXD3 expression potentially contributes to regulation of immune infiltration and cell proliferation in ccRCC, and the aberrant expression of MXD3 in tumor tissues could be caused by hypomethylation of gene promoter. MXD3 could be an effective prognostic biomarker and potential therapeutic target for ccRCC.

Objectives: To investigate the practicality of bladder mucosa reconstruction using an autologous peritoneal free graft in a rabbit model. Materials and methods: The bladder mucosa were reconstructed using autologous free peritoneal grafts after mucosa denudation in the rabbit models. Blood analyses, cystography, and urodynamic studies were performed at 1, 3, and 6 months postoperatively. Then the bladder specimens were harvested for histological analyses and immunohistochemical analyses. Results: Our urodynamic study suggested that the maximum bladder capacity and compliance in the experimental group were significantly lower than they were in the control group at 3 and 6 months postoperatively (P < 0.05), but there were no significant differences in the bladder leak point pressures at each time point (P > 0.05). Cystography suggested the bladder function was good, and no bladder contraction was seen in the experimental group. By 1 month after the bladder mucosa reconstruction, a histological analysis demonstrated that no peritoneum mesothelial cells were observed, and the reconstructed bladder mucosa was covered with 1-2 epithelial layers, which stained positively for CK 7 and uroplakin III but negatively for calretinin and vimentin. By 3 and 6 months, the layers of the epithelium increased to 3-5 lays, which is similar to native urothelia. Conclusions: This initial study showed that autologous free peritoneal grafts can be effectively used in bladder mucosa reconstruction. At 4 weeks after the operation, the peritoneal mesothelium regenerated completely into the uroepithelium. The newly formed tissue was histologically similar to native bladder mucosa.

Ileal neobladder construction is a common treatment for patients with bladder cancer after radical cystectomy. However, metabolic disorders caused by transposed bowel segments occur frequently. Bladder tissue engineering is a promising alternative approach. Although numerous studies have reported bladder reconstruction using acellular and cellular scaffolds, there are also disadvantages associated with these methods, such as immunogenicity of synthetic grafts and incompatible mechanical properties of the biomaterials. Here, we engineered an autologous peritoneal graft consisting of a peritoneal sheet and the seromuscular layer from the ileum. Three months after the surgery, compared with the neobladder made from the ileum, the reconstructed neobladder using our new method showed normal function and better gross morphological characteristics. Moreover, histopathological and transcriptomic analysis revealed urothelium-like cells expressing urothelial biomarkers appeared in the neobladder, while no such changes were observed in the control group. Overall, our study provides a new strategy for bladder tissue engineering and informs a variety of future research prospects.

富组氨酸糖蛋白(HRG)是一种具有多结构域,能够与多种配体相互作用并在多种生物学过程中发挥重要作用的血浆糖蛋白.早期对HRG的研究主要集中在凝血、纤维蛋白溶解、细胞黏附和免疫复合物清除等功能.近年来,HRG在调控肿瘤血管生成、调节肿瘤免疫和预测肿瘤预后的研究逐渐增多,HRG在肿瘤发生发展中的重要性逐渐被发现.全文对HRG在肿瘤中的作用相关研究进展进行综述.

目的 比较应用中性粒细胞与淋巴细胞比例(NLR)早期预测输尿管结石并发尿源性脓毒血症的应用价值.方法 回顾性分析142例输尿管结石患者的临床资料,其中92例输尿管结石患者无发热及泌尿系感染表现作为对照组,40例输尿管结石伴发脓毒血症但未出现感染性休克作为轻症脓毒血症组,10例输尿管结石伴发脓毒血症及感染性休克作为感染性休克组.比较3组患者血常规中性粒细胞百分比(N％)、NLR的差异,应用Logistic回归分析上述炎性指标与脓毒血症的相关性,评价炎性指标对感染严重程度的预测价值.结果 142例患者的平均年龄(53.22±13.66)岁,其中男性85例、女性57例.N％ 、N L R在3组患者中的表达差异均具有统计学意义,并且随着感染程度加重而升高.NLR诊断脓毒血症的受试者操作特征曲线下面积(A UC)=0.9404,高于N％ 的A UC=0.8853.以NLR=6.15作为诊断的临界值,其敏感度和特异度分别为86％ 和85.9％.结论 应用NLR能够早期预测上尿路结石并发尿源性脓毒血症的发生,相较于N％ 效果更好、速度更快.

目的 探讨输尿管软镜钬激光碎石取出术应用于治疗>2 cm上尿路结石的临床效果和安全性.方法 2014年1月～2017年1月收治的上尿路结石并行输尿管软镜钬激光碎石取出术治疗的病人102例,分析病人年龄、性别、结石大小、部位、碎石时间、结石清除、并发症等临床资料,总结分析手术有效性和安全性.结果 102例病人结石平均累计最大径线(CSD)(34.1±9.8)mm;平均碎石时间(28.56±20.45)分钟;平均手术时间(44.18±20.45)分钟;平均住院时间(7.2±2.4)天;102例病人中11例术后发生并发症,占10.78％,包括发热、腰痛、血尿、石街等,未见脓毒血症、感染性休克等严重并发症.多因素回归分析显示,病人术后结石清除率度的独立影响因素为肾积水,术后并发症发生危险因素为手术时间(P<0.05).结论 将输尿管软镜钬激光碎石取出术应用于临床直径大于2 cm的上尿路结石病人,临床安全性高;手术结石清除率与肾积水有关,手术时间长短是影响病人术后并发症发生的一种危险因素.

Background Clear cell renal cell carcinoma (ccRCC) is the most common malignant tumor of kidney with high mortality. The pathogenesis of ccRCC is complicated and effective prognostic predictors for clinical practice are still limited. This study aimed to identify significant genes with prognostic influence in ccRCC via bioinformatics analysis. Methods Four gene expression profiles were acquired from the Gene Expression Omnibus (GEO) database, including 168 ccRCC tissues and 143 normal tissues. Common differentially expressed genes (DEGs) between ccRCC tissues and normal kidney tissues were screened out. Then gene ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were investigated. Protein-protein interaction (PPI) network of the common DEGs was diagrammed and analyzed. Kaplan–Meier analysis was conducted to identify genes with prognostic influence in ccRCC. Gene Expression Profiling Interactive Analysis (GEPIA) was finally applied to validating differential expression of genes. Results Ninety-nine common DEGs between ccRCC tissues and normal kidney tissues were eventually screened out (P<0.05, |log FC| >2). GO functional analysis showed that the down-regulated genes were enriched in excretion, negative regulation of cell proliferation, heparin binding and cellular response to BMP stimulus, etc. KEGG pathway analysis indicated that the common DEGs were particularly enriched in HIF-1 signaling pathway and aldosterone-regulated sodium reabsorption. Seven core DEGs were distinguished through PPI network analysis, of which 6 core genes ANGPTL4, CA9, CXCR4, LOX, EGF and HRG showed significantly prognostic difference in patients with ccRCC by Kaplan–Meier analysis (P<0.05). And GEPIA confirmed these genes were expressed differentially between tumor and normal tissues (P<0.05). High expression of HRG was correlated with good OS in ccRCC patients. Specifically, HRG was commonly down-regulated in ccRCC tissues compared with normal tissues according to GEPIA. Conclusions Our study shows that high expression of HRG denotes a better prognosis in ccRCC patients. HRG is down-regulated in ccRCC tissues compared with normal kidney tissues. The selective expression pattern suggests that HRG could be a novel prognostic predictor and potential therapeutic target for ccRCC patients.

Objective To develop an ideal surgical procedure for neobladder reconstruction in experimental porcine models. Methods Six experimental female pigs weighting 28-33 kg underwent transplantation of autologous peritoneum for bladder reconstruction under general anesthesia.The flaps were used to reconstruct the orthotopic neobladder by suturing with the edges of the triangle and neck of the remnant bladder.The ureteral catheters were removed on the 5 th postoperative day and the balloon catheter was removed on the 7 th postoperative day.Voiding behaviour was monitored.The animals were euthanized at week 12 for routine pathology,immunohistochemistry,and electron microscopy. Results All the pigs survived after the surgery,and no postoperative complication such as peritonitis,intestinal obstruction,or urinary fistula was observed.All the peritoneum-ileum composite free valves survived after transplantation.Voiding behaviour was normal after catheter removal,and the urine was clear.At autopsy,reconstructed bladders were healthy.Pathological examination showed the neobladder had been covered by continuous urothelium while the peritoneum disappeared and showed no ileal mucosa regrowth and residual.Scanning electron microscope showed the transitional cells of neobladder were complete and orderly,and the urothelium around suture border was continuous and showed no malposition. Conclusions Reconstruction of bladder by autologous peritoneum and ileal seromuscular flaps is an ideal approach in the experimental pigs as it can prevent regrowth of ileal epithelial cells and avoid the complications of conventional enterocystoplasty.Its clinical application deserves further investigations.

目的 观察开放手术治疗Bricker术后输尿管肠吻合口狭窄的效果.方法 Bricker术后输尿管肠吻合口狭窄患者4例,均采用开放手术治疗,术中确认回肠通道及输尿管末端位置,仔细分离粘连,完整切除狭窄段,2例双侧吻合口狭窄行Wallace端端吻合,1例单侧吻合口狭窄行Nesbit端侧吻合,1例双侧吻合口狭窄怀疑恶性狭窄患者切除单侧肾输尿管全长及狭窄段后行Nesbit端端吻合.结果 4例手术均顺利完成.手术时间190～275 min;术中出血量20～100 mL,术中均未输血.其中1例出现吻合口漏尿,予观察后引流量逐渐减少.所有4例术后1个月拔除输尿管支架管.术后随访7～11个月,患者症状均缓解.拔除输尿管支架管后5个月复查肾功能,2例较术前好转,2例维持术前水平;复查CT,4例肾积水较前改善或维持术前水平.结论 Bricker术后输尿管肠吻合口狭窄临床处理棘手,采用开放手术治疗后随访无明显并发症,拔管后患者生活质量明显改善.

目的 提高对盆腔脂肪增多症的诊治水平.方法 回顾性分析4例盆腔脂肪增多症的临床症状、影像学表现和治疗结果,结合文献复习讨论盆腔脂肪增多症诊治特点.结果?2例患者行盆腔脂肪清除输尿管膀胱再植术.术中见盆腔脂肪组织明显增多,膀胱输尿管周围充满大量脂肪组织.术后复查IVU示肾盂输尿管积水减轻,血肌酐下降.1例患者行膀胱电切手术治疗腺性膀胱炎及膀胱出口梗阻,继续随访观察病情变化.1例行回肠通道手术,术后出现吻合口狭窄,应用球囊扩张治疗效果显著.结论?CT及MRI为本病的主要诊断依据,目前关于盆腔脂肪增多症的治疗尚无统一路径,应根据患者情况设计个体化治疗方案.定期随访十分重要.

Objectives To investigate the clinical effects of ureteroscopic treatment for tumors of upper urinary tract using the holmium laser. Method The clinical data of 7 patients with tumors of upper urinary tract treated with ureteroscopy and holmium from February 2008 to June 2018 were retrospectively reviewed.6 cases were female and 1 case was male, with an average age of 67 years old.Ureteroscopic laser treatment was performed successfully for the treatment of ureteral tumors in 5 patients and renal pelvic carcinomas in 2 patients.Result During the followup of 3 years, 4 patient remained tumor free.1 received nephroureterectomy and cystectomy because of tumor recurrence in the transplanted renal pevis and bladder. 1 received another ureteroscopic treatment because of tumor recurrence.1 patient died of tumor recurrence. Conclusion As to the low-risk tumors of upper urinary tract in patients, ureteroscopic treatment for tumors using the holmium laser is a safe and feasible choice, but strict postoperative surveilence is needed.

Objective To construct the rabbit models of orthotopic bladder cancer induced by N-methyl-Nitrosourea (MNUJ),and to evaluate the value of magnetic resonance imaging (MRI) in the diagnosis of the bladder cancer model.Methods 27 New Zealand white rabbits (weighing 2.5 kg) were randomly divided into experiment group (n =18) and control group (n =9).The experiment group were induced with MNU (10 mg per rabbit) by intravesical administration every other week for for 4 times.Meantime,the control group were treated with normal saline (5 ml per rabbit) by intravesical administration.At the end of the 8th,10th and 12th week,all rabbits were examined by MRI,then gross observation was performed for the bladder,and the specimens of the bladder were harvested for hematoxylin-eosin staining.Results In experiment group,17 rabbits were alived during the experiment and 1 rabbits were died at the end of the 6th week.In experimental group at the 8th week,no bladder tumor was detected by MRI and pathologcal examination in 5 rabbits.But some chronic inflammatory cells and fibroblasts were present in the bladder mucosa.At the 10th week,the abnormal signals were found in 5 rabbits by MRI which manifested as local bladder tumor,while 6 rabbits were identified non-muscle-invasive urothelial cell carcinoma by pathology.At the 12th week,abnormal changes were detected in each of the 6 rabbits by MRI scanning and manifested as thickening bladder wall,muscle-invasive urothelial cell carcinoma was diagnosed by pathology in each of rabbits.In control group,9 rabbits were all alived.There was no abnormal signal in the MRI examination and no bladder cancer in the pathological examination.The tumor response rates of bladder cancer in two groups had significant difference (P ＜ 0.05).The accuracy,sensitivity and specificity of MRI in the diagnoses of bladder cancer were 83.3％,85.7％,80.0％.Conclusion The methods to establish the rabbit models of orthotopic bladder cancer induced by MNU are simple and reliable;the results of MRI are consistent with the pathological results and MRI examination is a reliable diagnostic method concerning this model.

目的:评价经尿道膀胱肿瘤剥切术(TUSDBT)术毕即刻灌注吡柔比星(THP)治疗非肌层浸润性膀胱癌(NMIBC)的临床疗效.方法:从清华大学第一附属医院泌尿外科建立的膀胱癌云数据库中,严格按入组标准导出2009年1月1日-2016年12月31日接受TUSDBT+术毕即刻灌注+维持灌注治疗的NMIBC患者82例,将临床资料去隐私化后,导入SPSSAU进行线上统计分析.结果:随访时间为24.2～107.5个月,2年内未出现死亡病例,也无患者因膀胱灌注化疗的副作用停止灌注.入组患者在3、6、12、18、24个月内的复发情况分别为0例、4例(4.9％)、7例(8.5％)、8例(9.8％)、10例(12.2％),总复发率为24.4％,平均无瘤生存期为(25.69±20.67)个月,中位无瘤生存期为25.1个月.患者的性别、年龄、肉眼血尿、尿脱落细胞学阳性、肿瘤直径、肿瘤数目、病理分期、组织学分级、危险分组对2年复发率的影响均差异无统计学意义(P>0.05),但肿瘤数目与尿脱落细胞阳性对总复发率的影响差异有统计学意义(P<0.05).结论:对于经严格筛选的NMIBC患者,若TUSDBT中未发生膀胱穿孔等严重并发症,均应于手术室中即刻灌注,并辅以14次THP维持灌注治疗,可有效防止膀胱肿瘤复发,值得临床推广.

Objective: To establish experimental porcine model of reconstruction the neobladder by ileal seromuscular with transplantation of autologous peritoneum. Methods: This was an animal experiment carried out from January to April 2018 at animal center of Guizhou Medical University. Randomly 6 experimental female porcines were chosen, and their body weight was 28 to 33 kg. By intravenous anesthesia, the transplantation of autologous peritoneum for bladder reconstruction operation was carried out by transplanting the peritoneum onto an ileum segment which mucosa and submucosa had been removed. These flaps were used to mend and reconstruct the neobladder by suturing with edge of the detective bladder. After removal of ureteral catheters and balloon catheter at day 5 and day 7 respectively, voiding behavior was monitored, and animals were euthanized at week 12 for routine pathology, immunohistochemistry, and electron microscopic examinations. Results: Six porcines underwent reconstruction, but no one lost to complications such as peritonitis, ileus and urinary fistula. Voiding behavior was normal, and urine was clear in all animals after removal of catheters. At autopsy, reconstructed bladders were healthy. Pathological examination showed the part of reconstruction had been covered by continuous urothelium while the peritoneum disappeared and showed no ileal mucosa regrowth and residual. Scanning electron microscope showed that the transitional cells of neobladder were complete and orderly, and urothelium around suture border was continuous and no malposition. Conclusion: In this experimental porcine model, reconstruction bladder by autologous peritoneum and ileal seromuscular flaps is an ideal approach.

根治性肾输尿管全长切除+膀胱袖状切除一直被认为是治疗上尿路尿路上皮癌(UTUC)的金标准.对于孤立肾、双侧肿瘤及肾功能不全,或有保留肾脏意愿的患者,在充分评估之后可以考虑保留肾脏治疗.目前临床上已有多种有效的保肾手术方法,如内镜下肿瘤电凝灼烧或激光消融在低危UTUC的治疗中可以获得较好的肿瘤预后,但对于多发或肌层浸润性的肿瘤,其治疗效果则大大受限.输尿管节段性切除可以在保留患者肾脏的同时将肿瘤完全移除,即便对于内镜治疗效果欠佳的肌层浸润性肿瘤,也可以获得与根治性手术相当的肿瘤预后,同时又最大限度的保留了患者的肾功能.除此之外,局部药物灌注治疗在UTUC保肾治疗中也有一定的价值.

Objective: To explore the pathological mechanism and role of autologous peritoneum transplantation onenterocystoplasty in porcine model. Methods: Randomly, four experimental female swine were chosen, and each of their body weight was 28-33 kg. By intravenous anesthesia, the transplantation of autologous peritoneum for bladder reconstruction operation was carried out (to transplant the peritoneum onto an ileum segment of which the mucosa and submucosa had been removed. These flaps were used to mend and augment the bladder by suturing the edge of detective bladders). After removal of ureteral catheters and balloon catheter at day 5 respectively, their voiding behaviors were monitored, and respectively 2 swine were euthanized at week 3/6 for routine pathology, immunohistochemistry, and electron microscopic examinations. Results: Four swine underwent reconstruction, but none died for complications such as peritonitis, ileus and urinary fistula. The length of ileum was 35 cm, and the area of peritoneum was 15 cm×10 cm. Voiding behaviorsof the swine were normal, with clear urine after removal of their catheters. At autopsy, reconstructed bladders were healthy. Pathological examination showed the neobladder had been covered by continuous urothelium while the peritoneum disappeared without ileal mucosa regrowth or residual. Scanning electron microscope showed that the transitional cells of neobladder of swine were complete and orderly, and urothelium around suture border was continuous withoutmalposition. Conclusions: In porcine model, autologous peritoneal transplantation witnessed no immune rejection response for itself, which was replaced by crawling transitional epithelium around anastomosis, rather than by metaplasia.

Background The surgical alternatives are complicated for complex ureteral strictures or long defects such as nearly full-length ureteral avulsion and recurrent ureteral strictures after pyeloplasty or ureteroplasty with severe local adhesion. This study was performed to summarize our clinical experience in the treatment of complex ureteral strictures or defects with autologous urinary tract muscle flaps. Methods We retrospectively analyzed seven patients with complex ureteral strictures or defects. The seven patients comprised three men and four women ranging in age from 37 to 61 years (average age, 46 years). The causes of ureteral lesions were nearly full-length ureteral avulsion (n = 2), postoperative ureteral stricture after sigmoid augmentation cystoplasty (n = 1), and postoperative recurrent ureteral stricture due to local inflammation and local adhesion (n = 4). The lengths of the defects in the patients with ureteral avulsion were 22 and 24 cm, and the average length of the recurrent ureteral strictures was 5.2 cm (range, 4–8 cm). The patients underwent ureteroplasty using spiral bladder muscle flaps (n = 4), muscle flaps from the dilated ureter or pelvis segment proximal to the strictures (n = 2), or a bowel segment (sigmoid) (n = 1). Six-French double-J stents were placed in the repaired ureters. Results All operations were successful, and the ureteral double-J stents were safely removed under cystoscopy 8 weeks postoperatively. All of the patients had improvement of hydronephrosis, and none had ureteral strictures on intravenous urography or contrast CT. The patient with failed pyeloplasty was found to have enlarged kidney and dilated calyx postoperatively, but the degree was less severe than preoperatively and three-dimensional CT reconstruction showed renal pelvis reduction and a patent ureter with no stenosis at the reconstruction site. Renal function was normal in all patients. Conclusions Treatment of ureteral strictures or defects with autologous urinary tract muscle flaps can be performed in some complicated cases with good results.

长段输尿管修复重建对于泌尿外科医生而言始终是严峻的挑战.包括各种原因导致的输尿管狭窄、损伤如撕脱甚至断裂.针对不同的输尿管疾患学者们采用了多种术式进行治疗,但目前有关输尿管修复重建路径并无统一指导策略.为总结目前国内外输尿管修复重建研究进展,现就近年来相关报道进行系统综述.

目的 总结肾移植术后尿路上皮肿瘤的临床特点及诊治体会.方法 回顾性分析清华大学第一附属医院和解放军总医院第三医学中心2004-07至2017-12收治的31例肾移植术后尿路上皮肿瘤患者的临床资料.结果 31例肾移植术后尿路上皮肿瘤患者中,男10例,女21例,15例为输尿管肿瘤,7例为膀胱肿瘤,3例膀胱肿瘤同时合并输尿管肿瘤,5例肾盂肿瘤,1例移植肾肾盂癌.患者均接受手术治疗,其中17例患者术后肿瘤复发而再次接受手术治疗.随访期内6例因肿瘤复发死亡,1例因肠梗阻伴脓毒症死亡.结论 肾移植受者更易发生肿瘤,应早期诊断并根据肿瘤特点尽早采取积极的手术治疗措施.