饮水习惯与上尿路尿路上皮癌病理特征的相关性分析  

Correlation between daily fluid intake behavioral habits and pathological characteristics of upper tract urothelial carcinoma

作　　者：李志华[1,2] 徐纯如 刘颖[1,2] 贯华[1,2] 张萌[1,2] 车新艳 唐琦[1] 黄燕波[1,2] 李学松[1] 周利群[1] LI Zhi-hua;XU Chun-ru;LIU Yin;GUAN Hua;ZHANG Meng;CHE Xin-yan;TANG Qi;HUANG Yan-bo;LI Xue-song;ZHOU Li-qun(Department of Urology,Peking University First Hospital,Institute of Urology,Peking University,National Urological Cancer Centre,Beijing 100034,China;Department of Nursing,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院泌尿外科,北京大学泌尿外科研究所,国家泌尿男性生殖系肿瘤研究中心,北京100034 [2]北京大学第一医院护理部,北京100034

出　　处：《北京大学学报（医学版）》2022年第4期621-627,共7页Journal of Peking University:Health Sciences

摘　　要：目的:探究饮水习惯与上尿路尿路上皮癌(upper tract urothelial carcinoma,UTUC)患者的临床病理特征之间的相关性。方法:选取北京大学第一医院泌尿外科2020年8月至2021年7月收治的拟行根治性切除术的UTUC患者,在术前进行问卷调查,了解其饮水习惯,结合其术后病理特点进行统计分析。统计过程采用SPSS 22.0软件,首先采用列联表χ^(2 )检验,对UTUC肿瘤病理特点作为因变量与患者一般信息、既往史及饮水习惯相关因素等作为自变量逐一进行初步分析,筛选出针对各因变量病例组和对照组之间满足P<0.2的自变量,将筛选后的变量纳入二元Logistic回归分析,以P<0.05为差异有统计学意义。结果:共纳入239例患者,男性134例,女性105例,平均年龄(68.1±9.98)岁,中位病程4.8个月。统计结果提示,经调整了混杂因素的影响后,有白天每小时至少饮水1次习惯的UTUC患者患高级别(G3)肿瘤的概率增加(OR=1.941,95%CI:0.352~1.029,P<0.01);有白天每小时至少饮水1次习惯的患者相对于没有这一习惯的患者患多灶性UTUC肿瘤的发病风险显著下降(OR=0.344,95%CI:1.18~5.582,P=0.004),同时有每次饮水≥100 mL习惯的患者相对于无这一习惯者多灶性UTUC肿瘤的发病风险也显著下降(OR=0.477,95%CI:0.225~1.012,P=0.046);有自我关注每日饮水这一习惯的患者相对于无这一习惯的患者患肾盂癌的风险显著升高(OR=2.530,95%CI:1.434~4.463,P=0.001),而患输尿管癌的风险显著降低(OR=0.314,95%CI:0.172~0.573,P<0.01);其他纳入回归模型的变量对肿瘤病理特点发生的影响差异无统计学意义。结论:有白天每小时至少饮水1次、每次饮水≥100 mL、自我关注每日饮水等饮水习惯分别与上尿路尿路上皮癌病理特点(如肿瘤G3、肿瘤多灶性及肿瘤位于肾盂或输尿管)存在显著相关性,这一结论仍需后续更高证据等级的试验加以验证。Objective:To investigate the correlation between drinking habits and pathological characteristics of patients with upper tract urothelial carcinoma(UTUC).Methods:A preoperative questionnaire survey was conducted to understand the drinking habits of UTUC patients who were admitted to the Department of Urology,Peking University First Hospital for radical nephroureterectomy within one year from August 2020 to July 2021,and statistical analysis was performed in combination with their postoperative pathological characteristics.The statistical procedure was performed using SPSS 22.0 software,and firstly,the preliminary analysis was performed one by one using the columnarχ^(2 )test on the pathological characteristics of UTUC tumors as the dependent variable and the factors related to patients’general information,past history and drinking habits as the independent variables,and the independent variables that met P<0.2 between the case and control groups for each dependent variable were specified for screening.The screened variables were included in the binary Logistic regression analysis.A difference of P<0.05 was used to indicate a statistically significant difference.Results:A total of 239 patients,134 males and 105 females,with a mean age of(68.1±9.98)years and a median disease duration of 4.8 months,were included in this study.Multifactorial Logistic regression results suggested that after adjusting for the effects of other variables,UTUC patients who had the habit of drinking at least once every hour during the daytime had a significantly increased risk of high grade(G3)tumors(OR=1.941,95%CI:0.352-1.029,P<0.01);these patients also had a significantly decreased risk of multifocal UTUC tumors(OR=0.344,95%CI:1.18-5.582,P=0.004).The patients who had the habit of drinking over 100 mL water each time had a significantly decreased risk of mutifocal UTUC incidence(OR=0.477,95%CI:0.225-1.012,P=0.046).Patients who pay attention to daily water intakes had a significantly increased risk of renipelvic carcinoma(OR=2.530,95%C

关 键 词：上尿路尿路上皮癌 饮水习惯 病理特征 相关性分析 

分 类 号：R737.1[医药卫生—肿瘤]