目的 探讨膀胱肿瘤并类白血病反应的临床特点,以提高对膀胱肿瘤并类白血病反应的认识. 方法 对2013年太和医院收治的1例膀胱肿瘤并类白血病反应患者的临床资料进行回顾性分析,同时复习相关文献,分析其临床特点.结果 本例与相关文献报道的5例共6例患者纳入研究,其中男5例,女1 例,年龄(59.0±14.9)岁;临床分期均≥T3N0M0.文献纳入的5例患者均行膀胱根治性全切术,术前外周血白细胞最高水平平均为(70.68±25.49)×10.9/L,术后2周内3例患者血白细胞降至正常范围;1例明显下降,但未恢复正常;1例术后血白细胞不降反高于术前,该病例病情进展极快,术后1个月死亡.本例患者同时合并主动脉夹层及下肢静脉血栓,不适宜手术,确诊后予保守治疗,2个月后死于多器官功能衰竭.6例患者术后平均生存时间为(5.00±3.93)个月. 结论 膀胱肿瘤并类白血病反应较少见,高度恶性,预后不良,外周血白细胞计数可动态反映肿瘤的进展及控制情况.%Objective To explore the feature of bladder cancer with leukemoid reaction.Methods We describe 1 case of bladder cancer with leukemoid reaction.With the meanwhile, we review 5 previous reports.The clinical manifestations were summarized.Results In our case, the patient had a history of aortic dissection for 5 years with the meanwhile he was diagnosed with deep vein thrombosis and bladder cancer with leukemoid reaction who was not suitable for operation and died two months later.Total six cases, 5 men and 1 women, aged (59.0±14.9) years old.All the pathological stage group were ≥T3N0M0.5 cases underwent radical cystectomy, the reference range for the maximal elevated white blood cell count in the peripheral blood was (70.68±25.49)×10.9/L before the cystectomy.Two weeks after radical operation, the count of white blood cell in 3 cases were normal.One case did well postoperatively, but not reached to the normal and one case with higer leukocyte count who died one month after the operation and the mean survival time was (5.00±3.93) months after cystectomy.Conclusions In bladder cancer with leukemoid reaction is a rare occurrence and associated with a poor outcome.The increase of white blood cell in the peripheral blood can follow the clinical course of the underlying tumor and thus be useful for monitoring its evolution.
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