单中心214例非肌层浸润性膀胱癌复发因素分析  

Exploring the risk factors of recurrence in 214 patients with non-muscle invasive bladder cancer by retrospectively analysis

作　　者：吴雨征 杨同[1] 安泽生 薄志强[1] 张洪团[1] 张昌文[1] 徐勇[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300211

出　　处：《天津医科大学学报》2016年第6期516-519,共4页Journal of Tianjin Medical University

摘　　要：目的：分析影响非肌层浸润性膀胱癌复发的风险因素及其临床意义。方法：回顾分析214例非肌层浸润性膀胱癌患者的全部临床资料，对性别，年龄，体质量指数，是否合并高血压、糖尿病，肿瘤数量、大小（多发肿瘤以最大肿瘤直径定义）、分期、组织学分级，术后是否即刻灌注治疗，静脉化疗等因素进行生存分析，初次复发或进展为终点事件，运用Log-Rank检验，Kaplan-Meier法单因素分析比较各因素无病生存率差异，Cox比例风险回归模型多因素分析复发的独立风险因素。结果：214例非肌层浸润性膀胱癌患者平均就诊年龄68.5岁，男：女=1.4：1，随访时间8～48个月，复发63例（总复发率29.3%）。单因素分析发现，肿瘤数目，肿瘤大小，肿瘤分级，肿瘤分期，是否行即刻膀胱灌注治疗与复发相关有统计学意义（均P＜0.05）。多因素分析显示，肿瘤数目，肿瘤大小，肿瘤分级，肿瘤分期，是否行即刻膀胱灌注治疗是非肌层浸润性膀胱癌复发的独立预测因子。结论：肿瘤数目，肿瘤大小，肿瘤分级，肿瘤分期是非肌层浸润性膀胱癌复发的独立风险因素。膀胱即刻灌注是非肌层浸润性膀胱癌的保护因素。Objective ：To explore the main influencing factors and clinical significance of the recurrence of non-muscle invasive bladder cancer （NMIBC）. Methods： Two hundred and fourteen patients with NMIBC were retrospectively reviewed in single center. Gender, age,BMI ,hypert-ension,diabetes,tumor size, tumor number, tumor grade, tumor stage, immediately intravesical instillation and intravesical chemotherapy were predicted to be the risk factors.Survival analysis was carried out by employing Kaplan-Meier and Cox proportional hazard model. Results： Finally 214 patients with NMIBC were studied, with mean age of 68.5 years at presentation, and male to female ratio was 1.4∶1. Based on 8-48 months of following up, 63（29.3%） of 214 cases had recurrence .Univariate analysis indicated that number, size, grade and stage of tumor and immediate intravesical instillation were significantly associated with the recurrence of NMIBC （all P〈0.05）. Number, size, grade and stage of tumor and immediate intravesical instillation were independent risk factors for recurrence of NMIBC. Conclusion： number, size, grade and stage of tumor are the independent risk factors for recurrence of NMIBC. Immediate intravesical instillation is protective for recurrence of NMIBC.

关 键 词：膀胱肿瘤 复发 风险因素 

分 类 号：R737.14[医药卫生—肿瘤]