EORTC膀胱癌预后风险评分对NMIBC患者预后判断价值分析  

Prognostic Value of EORTC Bladder Cancer Prognosis Risk Score for NMIBC Patients

作　　者：余洋[1] 熊飞[1] 董自强[1] 陈晓波[1] 董传江[1] 张路生[1] YU Yang;XIONG Fei;DONG Ziqiang;CHEN Xiaobo;DONG Chuanjiang;ZHANG Lusheng(Department of Urologic Surgery,Yiehang Central People＇s Hospital,Yiehang Hubei 443000,Chin)

机构地区：[1]宜昌市中心人民医院泌尿外科,湖北宜昌443000

出　　处：《解放军预防医学杂志》2018年第7期922-924,936,共4页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：国家自然科学青年科学基金项目(No.81300626)

摘　　要：目的探讨欧洲癌症研究与治疗组织(EORTC)预后风险评分与非肌层浸润性膀胱癌(NMIBC)预后的相关性。方法选取我院2009年1月-2013年5月收治的140例NMIBC患者,所有患者均接受经尿道膀胱肿物电切术治疗,按照EORTC复发预测评分将患者分为<9分组、≥9分组,按照EORTC进展评分将患者分为<13分组、≥13分组,对所有患者进行术后随访观察,对比各组患者术后3年、5年的复发率、肿瘤进展率,并采用Cox比例风险回归模型分析各种临床及病理因素与预后的关系。结果 <9分组的3年复发率为25.00%,5年复发率为45.83%,均显著低于≥9分组患者的59.09%、77.27%,差异具有统计学意义(P<0.05);肿瘤分期增高、肿瘤分级降低、EORTC复发评分增加是NMIBC患者肿瘤复发的独立危险因素(P<0.05),术后患者即刻采用灌注化疗是NMIBC患者肿瘤复发的保护因素(P<0.05);肿瘤分期增高、肿瘤分级降低、EORT进展评分增加是NMIBC患者肿瘤术后进展的独立危险因素(P<0.05)。结论 EORTC预后风险评分增高与患者术后出现肿瘤复发、肿瘤进展关系密切,对于指导临床治疗具有重要价值。Objective To investigate the relationships between the EORTC prognostic risk score and the prognosis of non-muscle-invasive bladder cancer（ NMIBC）. Methods A total of 140 NMIBC patients admitted to our hospital between January 2009 and May 2013 were selected and all of them underwent transurethral resection of bladder tumors. The patients were divided into groups of 9 and ≥9 according to the EORTC recurrence prediction scores. According to EORTC progression scores,the patients were again divided into groups of 13 and ≥13. Follow-up observations were performed among all the patients. The recurrence rates and tumor progression rates at 3 years and 5 years after surgery were compared between these groups. The Cox proportional hazards regression model was used to analyze the relationships between clinical,pathological factors and prognosis. Results The 3-year recurrence rate of the 9 group was 25. 00% and the 5 year recurrence rate was 45. 83%,which were significantly lower than 59.09% and 77.27% in the ≥9 group,and the difference was statistically significant（ P 0. 05）. Increased tumor stage,reduced tumor grade,and increased EORTC progression scores were independent risk factors for tumor recurrence in NMIBC patients（ P〈0.05）. Immediate postoperative perfusion chemotherapy was a protective factor for tumor recurrence in patients with NMIBC（ P〈0.05）. Increased tumor stage,reduced tumor grade,and increased EORTC progression scores were independent risk factors for postoperative tumor progression in NMIBC patients（ P 0. 05）. Conclusion The higher risk score of EORTC is closely related to tumor recurrence and tumor progression after operation,which is of great value for clinical treatment.

关 键 词：欧洲癌症研究与治疗组织 预后 非肌层浸润性膀胱癌 

分 类 号：R737.14[医药卫生—肿瘤]