原发浅表性膀胱癌预后影响因素分析  

Analysis of the prognostic factors in patients with primary superficial transitional cell carcinoma of bladder

作　　者：曾福华[1] 杨土保[2] 江勃年[1] 刘志红[3] 谭春祈[1] 韩惟青[1] 李俊军[3] 杜兴[1] 

机构地区：[1]湖南省肿瘤医院腹外一科,长沙410006 [2]中南大学公共卫生学院流行病与卫生统计学系 [3]湖南省肿瘤医院病理科,长沙410006

出　　处：《中华泌尿外科杂志》2004年第10期669-672,共4页Chinese Journal of Urology

摘　　要：目的　探讨影响原发浅表性膀胱移行细胞癌复发、进展、膀胱保全、转移及肿瘤特异生存率等预后指标的主要因素。　方法　回顾性分析 198例原发浅表性膀胱移行细胞癌患者的生存资料 ,采用Kaplan Meier法、Log rank检验及Cox比例风险模型对影响预后的因素进行统计分析。　结果　平均随访 79.76个月。 3,5 ,10年的复发率分别为 ( 2 8.75± 0 .78) % ,( 35 .70± 0 .16 ) % ,( 4 2 .83± 0 .0 0 ) %。影响复发的主要因素是症状持续时间、组织学分级及术中输血。 3,5 ,10年的进展率分别为( 8.89± 0 .33) % ,( 15 .16± 0 .16 ) % ,( 2 3.88± 0 .0 0 ) %。影响进展的主要因素是术中输血、组织学分级、复查次数及首次无复发间期 (RFP)。 3,5 ,10年的膀胱保全率分别为 ( 94 .6 8± 0 .2 3) % ,( 93.87± 0 .0 0 ) % ,( 91.5 1± 0 .0 0 ) %。影响膀胱保全的主要因素为RFP。 3,5 ,10年的转移率分别为 ( 8.2 5±0 .2 2 ) % ,( 11.2 4± 0 .0 0 ) % ,( 2 8.94± 0 .0 0 ) %。影响转移的主要因素是 :肿瘤多灶性、肾积水、显微镜下生长形态及RFP。 3,5 ,10年的肿瘤特异生存率分别为 ( 95 .0 2± 0 .0 0 ) % ,( 90 .70± 0 .4 6 ) % ,( 77.14± 1.0 6 ) %。影响肿瘤特异生存率的主要因素是显微镜下生长形态及RFP。　?Objective To evaluate the prognostic factors affecting recurrence,progression,bladder preservation,metastasis and cancer specific survival in patients with primary superficial transitional cell carcinoma of bladder. Methods Using Kaplan Meier method,Log rank test and Cox proportional hazards model,the retrospective survival analysis was performed in 198 patients with primary superficial transitional cell carcinoma of bladder. Results The mean follow up period was 79.76 months.The recurrence rates at 3 ,5 ,10 year were (28.75±0.78)%,(35.70±0.16)%,and (42.83±0.00)%,respectively.The main variables affecting recurrence were the duration of symptoms,histological grades and intra operative blood transfusion.The progression rates at 3 ,5 ,10 year were(8.89±0.33)%,(15.16±0.16)%,and (23.88±0.00)%,respectively.The main variables affecting progression were intra operative blood transfusion,histological grades,the number of reexaminations and recurrence free period (RFP).The rates of bladder preservation at 3 ,5 ,10 year were(94.68±0.23)%,(93.87±0.00)%,(91.51±0.00)%,respectively. The main variable affecting bladder preservation was RFP. The metastasis rates at 3 ,5 ,10 year were (8.25±0.22)%,(11.24±0.00)%,(28.94±0.00)%,respectively.The main variables affecting metastasis were tumor multifocality, hydronephrosis,microscopic growth pattern and RFP. The cancer specific survival at 3 ,5 ,10 year were (95.02±0.00)%,(90.70±0.46)%,(77.14±1.06)%,respectively.The variables that could predict cancer specific survival were microscopic growth pattern and RFP. Conclusions By cancer specific survival analysis of the follow up data,we can well identify the main prognostic factors from numerous ones,and also can design the therapeutic and follow up strategies for primary superficial transitional cell carcinoma of bladder.

关 键 词：肿瘤 原发 RFP 预后 影响 膀胱 生存率 主要因素 结论 目的 

分 类 号：R737.14[医药卫生—肿瘤] R733[医药卫生—临床医学]