概述

输尿管癌症是指连接肾脏和膀胱的管道(输尿管)内部的细胞层出现异常生长。输尿管是尿路的一部分,将肾脏产生的尿液送往膀胱。

输尿管癌并不常见。患者多为老年人和先前接受过膀胱癌治疗的人。

输尿管癌和膀胱癌密切相关。形成输尿管内膜的细胞和形成膀胱内膜的细胞是同一类细胞。被诊断出输尿管癌的人有极大风险会患膀胱癌,因此,医生会建议检查膀胱癌体征。

通常采用外科手术治疗输尿管癌。在某些情况下,可能推荐使用化疗或免疫疗法。

症状

输尿管癌的体征和症状包括:

  • 尿液带血
  • 背痛
  • 排尿时疼痛
  • 体重意外下降
  • 疲劳

何时就医

如果持续存在的体征或症状令您担心,请约诊。

病因

目前尚不清楚引起输尿管癌的原因。

当输尿管内膜细胞 DNA 发生变化(突变)时,会发生输尿管癌。细胞的 DNA 包含指示细胞活动的指令。DNA 的上述变化则指示细胞快速增殖,并在超出典型生命周期后继续存活,这导致异常细胞的聚集物不断增大,可能堵塞输尿管或扩散到身体的其他部位。

风险因素

可能增加患输尿管癌的风险的因素包括:

  • 年龄增长。随着年龄的增长,患输尿管癌的风险增大。多数患者都是在七八十岁时诊断出这种癌症。
  • 既往膀胱癌或肾癌。被诊断出患膀胱癌或肾癌的人患输尿管癌的风险会增加。
  • 抽烟。抽烟会增大患输尿管癌和其他尿路癌症(包括肾癌和膀胱癌)的风险。
  • 癌症家族史。林奇综合征,又称遗传性非息肉性结直肠癌(HNPCC),会增加患结肠癌和其他癌症(输尿管癌)的风险。如果您有很强的癌症家族史,请与医生讨论。您可以综合决定是否考虑对林奇综合征和其他遗传性癌症综合征进行基因检测。

预防

Although there's no sure way to prevent ureteral cancer, you can take steps to help reduce your risk. For instance:

Don't smoke

If you don't smoke, don't start. If you smoke, talk with your healthcare professional about a plan to help you stop. Support groups, medicines and other methods may help you quit.

Take caution around chemicals

If you work with chemicals, follow all safety instructions to avoid harmful exposure.

Choose a variety of fruits and vegetables

Eat many different kinds of colorful fruits and vegetables. The antioxidants in fruits and vegetables may help reduce the risk of certain cancers.

Nov. 05, 2024

Living with 输尿管癌症?

Connect with others like you for support and answers to your questions in the Bladder Cancer support group on Mayo Clinic Connect, a patient community.

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  1. Bladder cancer. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1437. Accessed June 14, 2024.
  2. Partin AW, et al., eds. Urothelial tumors of the upper urinary tract and ureter. In: Campbell-Walsh-Wein Urology. 12th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed July 24, 2024.
  3. Gupta S, et al. Malignancies of the renal pelvis and ureter. https://www.uptodate.com/contents/search. Accessed July 24, 2024.
  4. DeVita VT Jr, et al., eds. Cancer of the bladder, ureter and renal pelvis. In: DeVita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology. 12th ed. ProQuest Ebook Central. Wolters Kluwer; 2023. Accessed June 14, 2024.
  5. Hematuria (blood in the urine). National Institute of Diabetes and Digestive and Kidney Disorders. https://www.niddk.nih.gov/health-information/urologic-diseases/hematuria-blood-urine. Accessed Aug. 16, 2024.
  6. Antioxidants and cancer prevention. National Cancer Institute. https://www.cancer.gov/about-cancer/causes-prevention/risk/diet/antioxidants-fact-sheet. Accessed Aug. 16, 2024.
  7. Powles T, et al. Enfortumab vedotin and pembrolizumab in untreated advanced urothelial cancer. New England Journal of Medicine. 2024; doi:10.1056/NEJMoa2312117.
  8. Childs DS (expert opinion). Mayo Clinic. Aug. 26, 2024.

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