体质指数对于根治性膀胱全切患者的临床特征和治疗结局的影响  

The Effect of Body Mass Index on Clinical Features and Prognosis Outcomes Following Radical Cystectomy for Bladder Cancer

作　　者：洪鹏[1] 李一帆[1] 方冬[1] 郭润碛 钟文龙[1] 郝瀚[1] 郑卫[1] 葛鹏[1] 巩艳青[1] 张争[1] 李学松[1] 林健[1] 周利群[1] 

机构地区：[1]北京大学第一医院北京大学泌尿外科研究所国家泌尿男性生殖系肿瘤研究中心,北京100034

出　　处：《肿瘤学杂志》2017年第7期567-573,共7页Journal of Chinese Oncology

基　　金：北京大学临床研究项目(PUCRP201302);北京市自然科学基金(7172219);首都卫生发展科研专项(2016-1-4077);首都临床特色应用研究与成果推广项目(Z151100004015173)

摘　　要：[目的]研究体质指数对膀胱癌根治性全切患者治疗及预后的影响。[方法]回顾性采集427例因膀胱癌行根治性全切患者的临床病理信息、治疗过程和随访结局,根据BMI将患者分成3组,分别是正常组(BMI<23kg/m^2)、超重组(BMI 23kg/m^2~24.9kg/m^2)和肥胖组(BMI≥25kg/m^2),采用单因素方差分析和非参数检验比较患者特征,通过Kaplan-Meier生存分析及单因素、多因素Cox回归分析预后差异。[结果]正常组、超重组和肥胖组的患者例数分别是148例、122例及157例。在基础临床特征方面,BMI高者合并高血压的比例较高(P=0.002);治疗过程方面,BMI高者手术时间长(P=0.001)、术中出血多(P=0.007);各组病理结局(肿瘤分期、分级、淋巴结状态)无明显差异。Kaplan-Meier分析显示3组的总体生存率和肿瘤特异性生存率无统计学差异。[结论]BMI高的膀胱全切患者合并高血压比例较高,手术时间较长,术中出血较多,但BMI对患者预后无明显影响。[Objective] To study the effect of body mass index （BMI） on treatments and prognosis outcomes following radical cystectomy for bladder cancer. [ Methods ] A retrospective review of 472 patients with bladder cancer following radical cystectomy was performed. We reviewed clini- copathologic data,treatments and follow-up outcomings. Patients were stratified in three groups of BMI featuring, normal weight （〈23kg/m^2） ,overweight （23-24.9kg/mz） and obese （≥25kg/m^2）. We used one-way ANOVA and nonparametric test to assess clinical and pathological variables ;and the prognosis differences were assessed using Kaplan-Meier method ,univariable and muhivariable Cox regression models. [Results] There were 148,122,and 157 patients in normal group,over- weight group, and obese group, respectively. As for clinical characteristics, patients with increased BMI suffered more from hypertension（P=-0.002） ;in terms of operation procedures, patients with in- creased BMI had longer operation time（P=0.001） and more blood loss（P=0.007）;among three groups, there was no difference in pathological outcomes （tumor staging, tumor grading and lym- phocyte node status）. Generally, no difference in overall survival rate and cancer specific survival rate was observed among three groups. [Conclusion] Bladder cancer patients following cystecto- my with increased BMI have higher risk of hypertension,longer operation time,and higher blood loss during cystectomy, however, BMI has little effect on the prognosis outcomes.

关 键 词：膀胱癌 体质指数 根治性膀胱全切术 治疗 预后 

分 类 号：R737.14[医药卫生—肿瘤]