术前红细胞分布宽度对根治性膀胱切除患者预后的临床意义  

Clinical significance of preoperative red cell distribution width on the prognosis of bladder cancer patients after radical cystectomy

作　　者：张子威 毛士玉 毛卫浦 杨帅[2] 郭亚东 王瑞良 姚旭东[1] ZHANG Zi-wei;MAO Shi-yu;MAO Wei-pu;YANG Shuai;GUO Ya-dong;WANG Rui-liang;YAO Xu-dong(Department of Urology,Shanghai Tenth People's Hospital,Tongji University,Shanghai 200072;Department of Urology,The First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)

机构地区：[1]同济大学附属上海市第十人民医院泌尿外科,上海200072 [2]蚌埠医学院第一附属医院泌尿外科,安徽蚌埠233000

出　　处：《现代泌尿外科杂志》2020年第8期697-701,共5页Journal of Modern Urology

基　　金：上海市科学委员会基金会(No.19411967700)。

摘　　要：目的研究术前外周血红细胞分布宽度(RDW)在根治性膀胱切除术患者预后中的临床意义。方法本研究对2009年1月至2018年11月期间共210例接受根治性膀胱切除术的患者进行了回顾性分析。采用X-tile软件来确定RDW的最佳临界值;采用Kaplan-Meier法来评估RDW对患者总生存期(OS)和无疾病进展期(PFS)的影响;采用卡方检验来比较两组患者的临床基线特征;采用Cox回归模型来分析影响根治性膀胱切除术患者预后的独立危险因素。结果RDW的最佳临界值是14.2;Kaplan-Meier法分析表明,术前高RDW组(>14.2)的膀胱癌患者与OS(Log-rank=6.703,P<0.05)和PFS(Log-rank=4.821,P<0.05)降低显著相关;低RDW组和高RDW组的患者在T分期上差异有统计学意义(χ^2=11.254,P=0.010);Cox多因素分析证实术前RDW是接受根治性膀胱切除术患者OS和PFS的预测因素。结论高RDW可以作为接受根治性膀胱切除术患者OS和PFS不良的危险因素。Objective To explore the clinical significance of preoperative red cell distribution(RDW)on the prognosis of bladder cancer patients after radical cystectomy.Methods The clinical data of 210 bladder cancer patients who underwent radical cystectomy during Jan.2009 and Nov.2018 were retrospectively analysed.The optimal cut-off value of RDW was determined with X-tile software.The effects of RDW on overall survival(OS)and progression-free survival(PFS)were evaluated with Kaplan-Meier analysis.The baseline clinical characteristics of patients were compared with Chi-square test.The independent risk factors for the prognosis after radical cystectomy were analysed with Cox regression model.Results The optimal cut-off value of RDW was 14.2.Kaplan-Meier analysis showed that bladder cancer patients with high preoperative RDW(>14.2)were significantly associated with lower OS(Log-rank=6.703,P<0.05)and reduced PFS(Log-rank=4.821,P<0.05).The difference in T stage between low and high RDW groups was statistically significant(χ^2=11.254,P=0.010).Cox multivariate analysis confirmed that preoperative RDW was a predictor of OS and PFS in bladder cancer patients after radical cystectomy.Conclusion High RDW is a risk factor of poor OS and PFS in bladder cancer patients after radical cystectomy.

关 键 词：膀胱癌 红细胞分布宽度 预后 独立危险因素 

分 类 号：R737.14[医药卫生—肿瘤]