膀胱原发性腺癌预后与肿瘤侵犯深度及术后化疗的相关性  

Correlation between Prognosis and Depth of Invasion and Postoperative Chemotherapy in Primary Bladder Adenocarcinoma

作　　者：张璐[1] 段伟[1] 孙晓东[1] 乔健[1] 张斌斌[2] 年亮 ZHANG Lu;DUAN Wei;SUN Xiao-dong(Department of Oncology,Yan'an University Affiliated Hospital,Yan'an,Shanxi 716000)

机构地区：[1]延安大学附属医院肿瘤科,陕西延安716000 [2]延安大学附属医院泌尿外科,陕西延安716000

出　　处：《医学临床研究》2020年第12期1844-1847,共4页Journal of Clinical Research

摘　　要：【目的】探讨膀胱原发性腺癌的肿瘤侵犯深度、术后辅助性化疗与患者预后的关系。【方法】在本院手术治疗的膀胱原发性腺癌患者78例,根据3年随访结局将患者分为生存组49例、死亡组29例;对比两组患者的年龄、性别、手术方式、病理分期、病理学分化程度、肿瘤数目、病灶最大径、浸润深度、淋巴结转移及术后辅助性化疗情况,采用Cox比例风险回归模型分析影响患者预后的相关因素。【结果】两组患者的年龄、性别、手术方式、肿瘤数目、病灶最大径之间比较差异均无显著性(P>0.05);生存组和死亡组患者的病理性分期、肿瘤分化程度、浸润深度、术后是否需要辅助性化疗比较差异具有显著性(P<0.05);采用Cox比例风险模型分析显示:膀胱原发性腺癌患者的病理性分期增高、肿瘤分化程度降低、发生肌层浸润是其不良预后的独立危险因素(P<0.05),术后进行辅助性化疗对患者的预后影响尚不明显(P>0.05)。【结论】影响膀胱原发性腺癌患者预后的因素很多,发生肌层浸润是其中一种独立危险因素,而术后辅助化疗的对预后的影响尚不显著,可能需要进一步延长观察时间进行研究。【Objective】To investigate the effect of tumor invasion depth and postoperative adjuvant chemotherapy on the prognosis of patients with primary bladder adenocarcinoma.【Methods】A total of 78 patients with primary bladder adenocarcinoma treated in our hospital were divided into survival group(49 cases)and death group(29 cases)according to the 3-year follow-up results.The age,gender,operation mode,pathological stage,pathological differentiation degree,tumor number,maximum diameter of lesion,depth of invasion,lymph node metastasis and postoperative adjuvant chemotherapy were compared between the two groups.Cox proportional hazard regression model was used to analyze the related factors affecting the prognosis of patients.【Results】There was no significant difference in age,gender,operation mode,tumor number and maximum diameter between the two groups(P>0.05);there were significant differences in pathological stage,tumor differentiation degree,depth of invasion,postoperative adjuvant chemotherapy between survival group and death group(P<0.05);Cox proportional hazard model analysis showed that:the increased pathological stage of primary bladder adenocarcinoma,the decreased tumor differentiation and myometrial invasion were independent risk factors for poor prognosis(P<0.05).Postoperative adjuvant chemotherapy had no significant effect on the prognosis of patients(P>0.05).【Conclusion】There are many factors that affect the prognosis of patients with primary bladder adenocarcinoma.Myometrial invasion is one of the independent risk factors.However,the effect of postoperative adjuvant chemotherapy on prognosis is not significant,which may need to be further extended for further study.

关 键 词：膀胱肿瘤 腺癌 预后 

分 类 号：R737.14[医药卫生—肿瘤]