膀胱镜检查频率对高危非肌层浸润性膀胱癌预后的影响  

Effect of cystoscopy frequency on surgical treatment and prognosis of high-risk patients with non-muscular invasive bladder cancer

作　　者：张会江[1] 尤升杰 李朋[1] 徐昭宇 包鹏飞 ZHANG Hui-jiang;YOU Sheng-jie;LI Peng;XU Zhao-yu;BAO Peng-fei(Department of Urology,Lishui People’s Hospital,Lishui,Zhejiang,323000,China)

机构地区：[1]丽水市人民医院泌尿外科,浙江丽水323000

出　　处：《中国卫生检验杂志》2022年第9期1087-1091,共5页Chinese Journal of Health Laboratory Technology

基　　金：丽水市科技局公益自筹类项目(2019SJZC46);丽水市科技局浙大合作项目(2018zdhz12);浙江省中医药科技计划项目(2020ZB309)。

摘　　要：目的对比分析膀胱镜检查频率对非肌层浸润性膀胱癌(NMIBC)患者经尿道电切术治疗情况及预后的影响。方法回顾性分析685例高危NMIBC患者的临床与随访资料,根据随访期膀胱镜检查次数分为低频率组(184例)和高频率组(501例),分析膀胱镜检查频率与经尿道手术次数、患者复发、进展及死亡之间的关系。结果低频率组农村人口多,膀胱灌注化疗比率低,经尿道手术次数少,阴性活检次数也少,与高频率组比较差异有统计学意义(P<0.05)。多分类Logistic回归分析结果显示膀胱镜检查频率高可增加经尿道手术次数,低频率组接受尿道手术的OR值为高频率组的53.3%,Fine-Gray竞争风险模型分析结果显示T1期患者中高频率组的累积复发与进展率及累积死亡率低于低频率组(HR值分别为0.334、0.411,P<0.05)。结论高频率的膀胱镜检查增加了NMIBC患者经尿道手术次数和阴性活检次数,但T1期患者在降低疾病死亡和进展风险方面,可能受益。Objective To compare the effect of cystoscopy frequency on the treatment and prognosis of patients with non-muscular invasive bladder cancer(NMIBC).Methods The clinical and follow-up data of 685 high-risk NMIBC patients were retrospectively analyzed.According to the number of cystoscopies performed during the follow-up period,the patients were divided into the low-frequency group(n=184)and the high-frequency group(n=501).The relationship between cystoscopy frequency and the number of transurethral operations,recurrence,progression,and mortality was analyzed.Results In the low-frequency group,the rural population was more,the ratio of bladder perfusion chemotherapy was lower,and the number of transurethral operations and negative biopsies were less.Compared with the high-frequency group,the differences were statistically significant(P<0.05).The results of multivariate Logistic regression analysis showed that the high frequency of cystoscopy could increase the number of patients undergoing transurethral surgery,and the OR value of urethral surgery in the low-frequency group was 53.3%of that in the high-frequency group.The results of Fine-Gray competitive risk model showed that the cumulative recurrence and progression rates and fatigue mortality rates in the high frequency group of T1 patients were lower than those in the low frequency group(HR=0.334,HR=0.411,P<0.05).Conclusion High frequency cystoscopy increased the number of transurethral operations and negative biopsies in NMIBC patients,but T1 patients may benefit in reducing the risk of disease death and progression.

关 键 词：膀胱镜 高危非肌层浸润性膀胱癌 死亡 进展 复发 经尿道手术 

分 类 号：R737.14[医药卫生—肿瘤]