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肾盂和输尿管的恶性肿瘤

Authors
Jerome P Richie, MD, FACS
Philip W Kantoff, MD
Section Editor
Seth P Lerner, MD
Deputy Editor
Michael E Ross, MD
Translators
石冰冰, 主任医师，教授

引言

肾集合小管、肾盏和肾盂，以及输尿管、膀胱和尿道的黏膜表面都具有相同的胚胎起源；术语“尿路上皮”用来描述这种覆盖尿路表面的上皮[1]。这种共同的胚胎起源对于处理这些部位发生的肿瘤具有重要意义。

本文将总结起源于肾盂或输尿管尿路上皮的恶性肿瘤的临床表现、诊断及治疗。起源于膀胱和尿道的尿路上皮肿瘤将单独讨论。 (参见“膀胱尿路上皮癌的初始处理和治疗概述”和“男性尿道癌”)

病理学

原发性肿瘤 — 上尿路、膀胱和尿道的尿路上皮(也被称为移行细胞)癌通常为多病灶的。这种现象称为“区域癌化”，这是因为整个尿路上皮都暴露于排泄到尿液中的或被尿液中水解酶激活的潜在致癌物，进而引起多灶性癌变。 (参见“膀胱肿瘤的病理学”和“膀胱尿路上皮(移行细胞)癌的流行病学和危险因素”，关于‘危险因素’一节)

起源于肾盂的原发性肿瘤包括尿路上皮癌、鳞状细胞癌和腺癌。

●超过90%的肾盂和输尿管肿瘤为尿路上皮来源，在组织学上与膀胱来源的尿路上皮肿瘤完全相同。

                                 

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Literature review current through: 2017-06 . | This topic last updated: 2017-01-12.
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