联苯胺致膀胱癌88例临床及预后分析

目的 探讨联苯胺所致职业性膀胱癌与普通人群膀胱癌的区别及终生监护的意义。方法 以尿脱落细胞检查及定量荧光影像分析作为早期诊断指标。根据膀胱癌确诊前是否进入监护网分组观察。结果 监护组39/53例通过定期普查，尿脱落细胞阳性后进一步确诊，需经腹手术者仅占29.4%，有41.2%可经尿道电切治疗；非监护组几乎全部因血尿就医，需经腹手术者占65.7%，可经尿道电切治疗者仅占14.3%，职业性膀胱癌临床分期高，具有明显的肿瘤多发性和再发性。88例膀胱癌中有11例患多原癌。结论 对有联苯胺接触史的人群进行医学监护可以早期发现，早期期诊断膀胱癌；对职业性膀胱癌应进行终身监护，多原癌病因是否与接触致癌物有关，有待进一步研究。

Clinic and Prognosis Analysis on 88 Cases of Urinary Bladder Carcinoma Caused by Benzidine

Objective The distinction between occupational carcinoma of urinary bladder caused by benzidine and non|occupational ones in general population and the significance of lifetime monitoring are explored.Methods The exfoliative cytologic examination in urine and quantitative fluorescence image analysis are used as early diagnostic indicators.Grouping observations were made according to whether the patients with carcinoma of urinary bladder were admitted into monitoring net before confirmed diagnosis.Results In the monitoring group,39 of 53 patients were diagnosed by periodic physical examination with positive results of exfoliative cytologic examination in urine.The patients treated with abdominal operation only accounted for 29^4%,but patients treated by urethral electrotomy were 41^2%.In the non|monitoring group,nearly all patients came to see doctor due to hematuria.Patients treated with abdominal operation accounted for 65^7%,by way of electrotomy only 14^3%,Clinical stage of occupational carcinoma of urinary bladder was high and mostly multiple and recurrent.11 of 28 patients with carcinoma of urinary bladder were primary carcinoma in multiple regions.Conclusions Carcinoma of urinary bladder can be found early and diagnosed by medical surveillance for the population with exposure history of benzidine.The lifetime monitoring for the carcinoma of urinary bladder caused by benzidine should be made.Whether the cause of primary carcinoma in multiple carcinoma regions relates to benzidine exposure needs to be further studied.