术前血浆纤维蛋白原与非肌层浸润性膀胱癌预后的相关因素分析  

Clinical significance of preoperative plasma fibrinogen level in predicting prognosis in patients with non-muscular invasive bladder cancer

作　　者：束坤鹏 丁德刚 徐豪 石红林 郝建伟 Su Kunpeng;Ding Degang;Xu Hao;Shi Honglin;Hao Jianwei(Department of Urology,Henan Provincial People's Hospital,Zhengzhou University People's Hospital,Henan University People's Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院(郑州大学人民医院,河南大学人民医院)泌尿外科,郑州450003

出　　处：《河南外科学杂志》2022年第3期7-11,共5页Henan Journal of Surgery

基　　金：河南省医学科技攻关计划项目(SBGJ202002002);河南省医学科技攻关计划项目(LHGJ20190603)。

摘　　要：目的探讨术前纤维蛋白原(Fib)与非肌层浸润性膀胱癌(NMIBC)预后的相关因素。方法回顾性分析2017-09—2018-08河南省人民医院泌尿外科行经尿道膀胱肿瘤电切术(TURBT)的73例NMIBC患者的临床和病理资料。结局指标为术后无复发生存时间(RFS)、术后无进展生存时间(PFS)。根据受试者工作特征曲线(ROC曲线)确定术前Fib的最佳截断值后分为Fib高值组(Fib>3.14g/L,n=26)、Fib低值组(Fib≤3.14g/L,n=47),并同其他临床、病理指标进行生存分析。结果ROC曲线中,Fib预测术后是否复发的曲线下面积(AUC)为0.635,最佳诊断点为Fib=3.14。Fib高值组术后复发风险高于Fib低值组,差异有统计学意义[风险比(HR):3.10,95%可信区间(CI):1.19~8.10;P=0.021]。对于无进展生存期,2组进展风险的差异无统计学意义(HR:2.36,95%CI:0.70~8.00;P=0.167)。多因素分析显示,Fib高值不是影响TURBT术后复发的独立危险因素。结论术前Fib高值是NMIBC患者TURBT术后复发的危险因素之一,但需要更多的临床研究予以验证。Objective To investigate the clinical prognostic value of preoperative fibrinogen(Fib)in patients with non-muscular invasive bladder cancer(NMIBC)undergoing transurethral resection of bladder tumor(TURBT).Methods The clinical and pathological data of 73 patients with NMIBC who underwent TURBT in Department of Urology,Henan Provincial People's Hospital from September 2017 to August 2018 were retrospectively analyzed.The outcome indicators were postoperative recurrence-free survival time(RFS)and progression-free survival time(PFS).According to the receiver operating characteristic(ROC)curve,the optimal cut-off value of preoperative Fib was determined and then the included patients were divided into high Fib value group and low value group,and survival analysis was performed with other clinical and pathological indicators.Results In the ROC curve,the area under the curve(AUC)of Fib for predicting postoperative recurrence was 0.635,and the optimal cut-off point was Fib=3.14.Compared with the low Fib group(Fib≤3.14g/L,n=47),the high Fib group(Fib>3.14g/L,n=26)had a higher risk of postoperative recurrence[hazard ratio(HR):3.10,95%confidence interval(CI):1.19~8.10;P=0.021],but there was no significant statistical difference between the two groups for PFS[HR:2.36,95%CI:0.70~8.00;P=0.167].However,the high value of Fib in multivariate analysis was not an independent risk factor for recurrence.Conclusion The preoperative high Fib value is one of the risk factors for recurrence of NMIBC patients undergoing TURBT,and more clinical trials are needed to verify it.

关 键 词：非肌层浸润性膀胱癌(NMIBC) 纤维蛋白原(Fib) 经尿道膀胱肿瘤电切术(TURBT) 无复发生存时间(RFS) 

分 类 号：R737.14[医药卫生—肿瘤]