上尿路尿路上皮癌根治术后膀胱肿瘤复发的危险因素分析  

Risk factors for recurrence of bladder cancer after resection of upper urinary tract urothelial carcinoma

作　　者：王超[1] 姜行康[1] 李慧[1] 齐士勇[1] 徐勇[1] 

机构地区：[1]天津医科大学第二医院天津市泌尿外科研究所,天津300211

出　　处：《山东医药》2015年第18期18-20,共3页Shandong Medical Journal

基　　金：天津市应用基础及前沿技术研究计划(12JCYBJC31400)

摘　　要：目的探讨上尿路尿路上皮癌(UUT-UC)患者行根治性肾输尿管切除术(RNU)后膀胱肿瘤复发的危险因素。方法对209例行RNU的UUT-UC患者进行术后随访,记录膀胱肿瘤复发情况。分析UUT-UC的临床病理特征与术后膀胱肿瘤复发的关系,用Log-rank检验比较生存曲线。结果 209例患者中,术后膀胱肿瘤复发59例(28.2%)。肿瘤多发者的膀胱肿瘤复发率为46.0%,明显高于单发者的22.0%(P<0.01);术前行输尿管镜检者的膀胱肿瘤复发率为46.7%,明显高于未行输尿管镜检者的31.5%(P<0.01)。结论 UUT-UC患者的肿瘤病灶数以及术前是否行输尿管镜检术可作为判断患者根治性肾输尿管切除术后膀胱肿瘤复发的危险因素。Objective To investigate the clinicopathological risk factors for intravesical recurrence （ IVR） in patients undergoing radical nephroureterectomy （RNU） for upper urinary tract urothelial carcinoma （UUT-UC）.Methods The postoperative follow-up was conducted in 209 patients who underwent RNU for UUT-UC, and the case of IVR was recorded . We analyzed the relationships between the clinical and pathological features of UUT -UC with IVR.The Log-rank test was used to calculate survival functions .Results Of 209 patients, 59 cases （28.2%） developed IVR after RNU.The IVR rate of multifocal tumors was 46.0%, which was significantly higher than that of the single tumor （22.0%） （P〈0.01）. The IVR rate in patients who underwent preoperative ureteroscopy was 46.7%, which was significantly higher than those who did not undergo ureteroscopy （31.5%） （P＆lt;0.01）.Conclusions Tumor multifocality and diagnostic ureteroscopy are the risk factors in developing IVR after RNU for UUT-UC.

关 键 词：尿路上皮癌 根治性肾输尿管切除术 膀胱癌 肿瘤复发 肿瘤多灶性 输尿管镜检术 

分 类 号：R737.1[医药卫生—肿瘤]