What Is a Mucinous Cystadenocarcinoma?

Mucinous adenocarcinoma of the bladder, also known as bladder-like carcinoma, bladder adenocarcinoma, or bladder signet ring cell carcinoma, refers to a glandular structure in the entire tumor.

Bladder mucinous adenocarcinoma

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Bladder mucinous adenocarcinoma includes primary bladder mucinous adenocarcinoma, umbilical urinary adenocarcinoma, and metastatic adenocarcinoma. Among them, primary bladder mucinous adenocarcinoma accounts for 0.9% -2% of bladder cancer. Mucinous adenocarcinoma of the bladder can occur at any age, and the incidence rate gradually increases after the age of 40. The ratio of male to female is 2.70 to 3.20: 1. The most common symptom is gross hematuria. Followed by symptoms of urinary tract irritation, manifested as frequent urination, urgency, dysuria, and lower abdominal discomfort. Surgical treatment is the main method, and radiotherapy and chemotherapy are not sensitive.

Bladder mucinous adenocarcinoma

adenocarcinoma of bladder

mucinous carcinoma of bladder; bladder carcinoma; bladder adenocarcinoma; bladder signet ring cell carcinoma

Urology> Urogenital tumors> Bladder tumors

Oncology> Abdominal Cancer> Bladder Cancer

C67

Chemical carcinogen-induced bladder cancer has been confirmed, but there are also many patients with bladder cancer who have no history of exposure to chemical carcinogens. At present, the more common view is that viruses or certain chemical carcinogens act on human proto-oncogenes, making them activated as cancer gene. It is related to the following factors: The types of jobs exposed to aromatic substances for a long time, such as dyes, leather, rubber, painters, etc., increase the incidence of bladder tumors. Scholar statistics before 1954. Among workers exposed to aniline, the incidence of bladder cancer is 30 times higher than that of the general population. Benzidine, 4,4-diaminobiphenyl, 4-aminobiphenyl, -naphthylamine, etc. are all considered as More certain foreign chemical carcinogens. These substances enter the body. After being metabolized by the liver, it is excreted by the kidneys into the bladder, and then degraded by -glucuronidase to -aminonaphthoic acid, which causes carcinogenesis and causes occupational bladder cancer. The incubation period of these substances for carcinogenesis is relatively long, reaching about 20 years. Smoking is also a cause of increasing the incidence of bladder tumors. In recent years, studies have shown that the metabolism of tryptophan in the urine of smokers has increased by 50%. When smoking is stopped, tryptophan levels return to normal. Rose and Walleace (1973) study showed that the chemical composition of urine of bladder cancer patients in smoking and non-smoking groups had higher tryptophan levels, and smokers showed higher levels. Non-smokers are low. They also found that vitamin C reduced tryptophan activity in smokers and nonsmokers. Tryptophan metabolism is abnormal in the body. The abnormal metabolism of tryptophan can produce some metabolites, such as 3-hydroxy-2-aminoacetophenone, 3-hydroxy-anthrenilic acid ), Can directly affect the cell's DNA and RNA synthesis, these metabolites are excreted into the bladder after being metabolized by the liver, and have carcinogenic effects after -glucuronidase. Often these carcinogens are significantly increased in the urine of bladder tumor patients. Local long-term stimulation of the bladder mucosa, such as chronic chronic infection, long-term stimulation of bladder stones, and urinary tract obstruction, may be factors that induce tumors. Glandular cystitis and leukoplakia are considered precancerous lesions. drugs. In recent years, taking drugs to cause bladder cancer has also attracted attention. For example, taking a lot of phenacetine drugs has been proven to cause bladder cancer. Parasitic diseases. The incidence of bladder cancer is quite high in patients with severe schistosomiasis. Human papillomavirus DNA may combine with certain DNA fragments that regulate apoptosis, interfere with the transmission, transcription, and replication of these genes, and regulate the cell cycle in multiple links to exert its carcinogenic effect. The incidence of bladder cancer is also related to ethnic and environmental factors.

Adenocarcinoma accounts for less than 2% of primary bladder cancer and is divided into 3 categories: primary bladder mucinous adenocarcinoma, umbilical carcinoma, and metastatic adenocarcinoma. Adenocarcinoma can also occur in the intestinal tract and replace the urethral channel, and enlarge the bladder. Primary bladder mucinous adenocarcinomas occur predominantly at the bottom of the bladder (triangular area, neck, and side walls) and at the top of the bladder. Adenocarcinoma has the highest incidence in eversion of the bladder. Histological types of intestinal adenocarcinoma such as signet ring cell carcinoma and gelatinous carcinoma can occur in the bladder. Adenocarcinoma may be papillary or solid. Most adenocarcinomas are poorly differentiated and infiltrated. Umbilical carcinoma is extremely rare. Most adenocarcinomas originate from the outer wall of the bladder and infiltrate the bladder. Umbilical carcinoma can spread around the bladder. Bloody or mucus secretions or mucus cysts can appear in the umbilicus, and mucus can appear in the urine if the bladder cavity is involved. Metastatic adenocarcinoma mainly comes from the rectum, stomach, breast, prostate and ovaries.

1. The most common clinical manifestation is gross hematuria. Followed by symptoms of urinary tract irritation, including urinary frequency, urgency, dysuria, lower abdominal discomfort, etc .; some patients have mucous urine, varying amounts of mucus, and thick mucus can also block the urethra and cause urinary retention. This is the bladder mucus gland One of the characteristics of cancer.

2. Adenocarcinoma originated from the umbilical cord of the bladder. The location is concealed and mostly asymptomatic, but some patients can touch the mass in the lower abdomen. Symptoms of infiltration and metastasis may occur in the later stages.

The urine is cloudy and the amount of mucus is large. Tumor cells were detected in mucus and necrotic exudates in urine, and the positive rate was higher.

According to the clinical manifestations and diagnosis of bladder mucinous adenocarcinoma, there is generally no difficulty, but the diagnosis of early bladder mucinous adenocarcinoma is not easy. It is necessary to pay attention to the characteristics of the medical history and the related auxiliary examination to make an early diagnosis.

The diagnostic criteria for primary bladder mucinous adenocarcinoma: tumors mostly occur on the side and bottom of the bladder; often accompanied by glandular or cystic cystitis; there is a transitional lesion between the cancer and normal bladder epithelium; there is no other cause Cancer.

The diagnostic criteria of urinary urinary adenocarcinoma: the tumor is located on the top or anterior wall of the bladder; there is no cystic or glandular cystitis; the tumor starts in the inner part of the bladder wall of the urinary ureter, infiltrates the muscle layer or deeper, and the bladder Often intact or ulcerated; The tumor is clearly delimited from the surrounding or surface, but branches extend to the bladder space; Umbilical urethral remnants are found; and suprapubic mass; There are no other primary cancers throughout the body.

Hematuria is the main symptom of bladder tumors. The differential diagnosis of bladder tumors is mainly the differential diagnosis of hematuria.

1. Total bladder resection and pelvic lymph node dissection are preferred for the treatment of bladder mucinous adenocarcinoma. Transurethral bladder tumor resection (TURBT) is generally not available.

2. For small tumors confined to the top, side and anterior wall of the bladder, partial bladder resection may be considered, and the margin should be more than 3 cm from the tumor. Partial bladder resection is also a good choice for small, well-differentiated umbilical carcinoma.

3. Bladder mucinous adenocarcinoma is not sensitive to radiotherapy and chemotherapy. Adjuvant therapy has a certain effect.

Bladder mucinous adenocarcinoma has a poor prognosis, with a 5-year survival rate of about 33%. The reasons are: it is advanced at the time of diagnosis; the tumor is deeply infiltrated and metastasizes early; the tumor cells are highly malignant and easily metastatic; the failure to diagnose adenocarcinoma before surgery results in incomplete surgical resection; Radiotherapy is not sensitive.

There are 5 aspects of bladder cancer prevention:

Take preventive measures against the cause, such as dyes, rubber, leather, and other types of carcinogens that have been confirmed to cause bladder cancer. The incidence of bladder cancer is significantly increased by smoking and taking certain drugs. This requires improvement of dyes. , Rubber, leather, and other industrial conditions, it is recommended to ban smoking and avoid large-scale and long-term use of drugs that can cause bladder cancer.

Pay close attention to the close follow-up of hematuria patients, especially for unexplained gross hematuria in men over 40 years of age. In principle, strict formal diagnostic tests should be taken to screen for bladder tumors, including cystoscopy.

Carry out mass census work, especially for the population with high incidence.

Strengthen basic and clinical research work, including improving the accuracy of non-invasive examination, early diagnosis of bladder tumors, and developing drugs to prevent recurrence of bladder tumors.

Carry out tumor education and education, popularize relevant medical knowledge, and improve the public's awareness of urinary tract tumors, so that they seriously participate in regular medical examinations, establish awareness of early medical treatment, and facilitate early diagnosis of bladder tumors.

Glucose, oxygen, vitamin C, benzoic acid

Tryptophan, Vitamin C