TURBT后病理组织标本中肌层组织存在与否作为预测手术质量指标的可行性研究  

Feasibility study on prediction of operation quality index by existence or non-existence muscle tissues in pathological specimens from TURBT

作　　者：王文龙[1] 张羽[1] 胡海龙[1] 王意涵[1] 李胜[1] 邢晨[1] 吴长利[1] 

机构地区：[1]天津医科大学第二医院泌尿外科,天津市泌尿外科研究所,天津市泌尿外科基础医学重点实验室,天津300211

出　　处：《临床泌尿外科杂志》2015年第5期416-419,424,共5页Journal of Clinical Urology

基　　金：国家自然科学基金资助项目(编号30700834);天津市自然科学基金资助项目(编号12ZCDZSY16600)1

摘　　要：目的：探讨经尿道膀胱肿瘤电切术（TURBT）后病理组织标本中有无肌层组织是否可以作为评价手术质量的指标。方法：回顾性分析2013年1月～2013年12月收治的339例行TURBT治疗的膀胱癌患者临床资料，并观察其病理组织切片，评价肿瘤的大小、数目、形态、位置、分期和分级与病理切片中是否存在肌层组织的关系，并评价是否存在肌层与肿瘤复发的关系。结果：339例患者中，病理组织切片中存在肌层组织的患者272例（80．24％）。单因素分析表明肿瘤分期、分级及大小与病理组织切片中有无肌层组织相关。Ta／T1期肿瘤病理组织切片中存在肌层和不存在肌层患者的复发率分别为30．00％和44．78％，P=0．003，差异具有统计学意义。结论：TURBT后病理组织切片中是否存在肌层与肿瘤的复发相关，从而可以作为评价TURBT手术质量的指标。该指标可指导术者更彻底切除肿瘤，降低肿瘤复发率，在非肌层浸润性膀胱癌诊治中具有重要临床价值。Objective.. To evaluate whether the presence of detrusor muscle in bladder tumor specimens after transurethral resection can be a significant marker of surgery quality. Method All of 339 cases with bladder cancer were treated with transurethral resection of bladder tumor （TURBT） from January 2013 to December 2013 and their tumor specimens were reviewed. The end points were non-existence or existence of detrusor muscles in the surgical specimen and its association with tumor＇s shape, number, size, position, stage, grade and disease recur- fence. Result..Detrusor muscle in the surgical specimen was found in 272 of the 339 study patients （80.24%）. Uni- variate analyses revealed that the size, stage and grade of tumor were associated with the presence of detrusor muscle in the resected specimens. The recurrence of Ta or T1 tumor between attendance of detrusor muscle group and absence of detrusor muscle group was statistically significant, with a recurrence rate of 30.00% and 44.78%, respectively （P= 0. 003）. Conclusion： The presence or absence of detrusor muscle in apparently complete TURB.T specimen shows significant association with recurrence and may be an important marker of resection quality. More- over, it can be clinical helpful to effectively resect the lesions for surgeon and lead to a lower recurrence.

关 键 词：膀胱癌 经尿道膀胱肿瘤电切术 肿瘤复发 肌层组织 

分 类 号：R737.14[医药卫生—肿瘤]