膀胱腫瘍の臨床統計 - 第1報 発生頻度,膀胱鏡所見,組織学的所見について

Abstract

Statistical analysis was performed on tumors of the urinary bladder seen in the Department of Urology of Nagoya City University Hospital during 20 years from January of 1923 to December of 1942. In this report, incidence rate, cystoscopic findings and histological findings were studied. 1) Number of patients with primary bladder tumor was 178 during 20 year period, which was calculated as 0.86% of all the outpatients of these cases, 129 were male and 49 were female, the male-to-female ratio being 2.6. Annual increase or decrease of incidence rate was not observed. The age distribution ranged from 18 to 94 and the majority of patients were in the sixth decade. The total of over 50 year-old age groups occupied 82%. 2) Sixty-one per cent of all the tumors were single and 39% were multiple. Fifty-four per cent of all tumors were "small" (rice-grain sized~thumb's head sized) and 33% were "medium" (thumb's head sized~walnut sized). Twenty five per cent of all tumors were papillary and pedunculated, 36% were papillary and sessile, 38% were non-papillary and sessile. Thirty-five per cent of all single tumors were located on the lateral wall and 30% on the posterior wall. However, as to multiple tumors, 29% were located on the posterior wall and 26% on the lateral wall. 3) Histological patterns of the tumors consisted of 77 cases of transitional cell carcinoma, 3 of adenocarcinoma and 3 of squamous cell carcinoma. According to Ackerman's classification, distribution of 72 cases of transitional cell carcinoma showed 22 grade 1, 22 grade 2, 24 grade 3, and 6 grade 4. 4) The grade of transitional cell carcinoma was examined in relation to chief complaints, size of tumors, gross appearance of tumors, number of tumors and age of cases. a) Hematuria occured as chief complaint in 58% of all cases. Pain on urination occurred in 15%, frequency of urination in 13%, dysuria in 7% and other complaints in 7%. No relationshipwas observed between the grade of transitional cell carcinoma and chief complaints. b) The grade of transitional cell carcinoma was correlated with size of tumors. Small tumors were benign (P<0.05) and large tumors were malignant (p<0.01). c) Only 5% of grade 1 tumors were non-papillary and sessile. None of grade 4 tumors were papillary and pedunculated. Papillary tumors were benign (p<0.01) and pedunculated tumors were also benign (p<0. 05). d) There was little relationship between the grade and number of tumors. However, multiple tumors which occurred over 9 in number were relatively malignant in comparison with multiple tumors which were under 9. e) No relationship was observed between the grade and age of cases.