尿路系悪性腫瘍患者の受診契機に関する検討

Abstract

尿路系悪性腫瘍患者の主訴と受診契機を解析し, 都市部大学病院の癌患者の受診動向を検証した.腎細胞癌では検診と他疾患精査群が全体の半数を超え, 無症候例が約80%に達していた.腎盂尿管癌では肉眼的血尿が最も高く, 時には100%に達していた.膀胱癌でも肉眼的血尿が最も高く, 80%前後が肉眼的血尿を主訴としていた.前立腺癌では排尿困難, 頻尿などの排尿症状が最も高く, 比率は50-70%前後であった.PSAにより発見は1995年以降増え始めた.偶発癌は腎細胞癌で頻度および実数とも有意に高かった.膀胱癌と腎盂尿管癌は原発巣に基づく症状の主訴が大半であった.転移に基づく症状が主訴となった例は前立腺癌で有意に高かった

We analyzed the chief complaints of patients with four major urogenital malignancies (renal cancer, renal pelvis and ureter cancer, bladder cancer and prostatic cancer) over the past decade (1990-1999) at the Jikei University Hospital. Over the last 10 years, a high percentage of renal cancers were detected incidentally. By contrast, prostatic cancers were more likely (10.5%) than other cancers to be detected on the basis of symptoms of metastasis. However, since 1995 more prostatic cancers are being detected with prostatic-specific antigen screening at the health checkups. Gross hematuria is the chief complaint of most patients with uroepithelial cancers (cancers of the renal pelvis, ureter and bladder cancer). Additionally, renal pelvis and ureter cancers were diagnosed with screening in a few patients in the past five years.