職業性膀胱癌: スクリーニング開始後20年間における臨床成績とその意義

Abstract

A total of 90 dyestuff workers who were engaged in the production of aromatic amines during the post-war period after the 2nd world war have been examined since 1967 by exfoliative cytologic examination. Those identified as class-3 or over by this first screening test were then submitted to a second screening which consisted of periodic cystoscopic examination and 1 or 2 intravenous pyelographies per year. This system of mass screening has been used for the past 20 years, and we have discovered 23 cases of bladder tumor, a case of asynchronous bilateral ureteral tumor and a case of ureteral tumor. Out of the 13 cases, bladder tumors were discovered in 6 cases within 3 months after a positive exfoliative cytology result and in 5 cases within 1 year. The presence of a tumor was confirmed in 85% of those patients within 1 year and in all of them in about 3 years. Periodic examinations have revealed all the tumors when they were about 5 mm in size and in stage 0 through A, demonstrating the usefulness of systematic examination. Treatment included intravesical instillation of anticancer agents, mostly mitomycin C, for 7 cases transurethral resection (TUR) for 8 cases and partial cystectomy was performed in one case. One patient with an asynchronous bilateral ureteral tumor was treated first by right total nephro-ureterectomy with cuff resection of bladder, and later by ureter excision and nephrostomy. This patient died of ileus in the 7th year of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)