膀胱肿瘤与膀胱壁接触长度及角度预测肌层浸润性膀胱癌的价值  

Exploration of the Value of the Contact Length and Angle Between Bladder Tumor and Bladder Wall in Predicting Muscle Invasive Bladder Cancer

作　　者：吴月 陈松丽 赵静[2] 戚琪 周爱云[1] 李耀辉 徐盼[1] Wu Yue;Chen Songli;Zhao Jing;Qi Qi;Zhou Aiyun;Li Yaohui;Xu Pan(Department of Ultrasound,The First Affiliated Hospital of Nanchang University,Nanchang 330006,China;Department of Radiology,Jiangxi Maternal and Child Health Hospital,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院超声医学科,南昌市330006 [2]江西省妇幼保健院放射科,南昌市330006

出　　处：《中国超声医学杂志》2023年第2期201-204,共4页Chinese Journal of Ultrasound in Medicine

基　　金：江西省卫生健康委科技计划(No.202210455)。

摘　　要：目的 探究常规超声检查中,膀胱肿瘤与膀胱壁接触长度(CL)及角度在预测肌层浸润性膀胱癌(MIBC)的作用。方法 回顾性分析经病理证实的140例膀胱癌患者,其中MIBC组41例,非肌层浸润性膀胱癌(NMIBC)组99例,比较组间超声特征差异。使用多因素回归分析筛选MIBC的独立危险因素并建立诊断模型。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评价模型在膀胱癌侵袭性上的诊断效能。结果 MIBC组与NMIBC组相比,更常表现为多发、直径>3 cm(P<0.05)。MIBC组的病灶直径、CL、总角度(TA)、接触长度与肿瘤周长的比值(CL/C)显著高于NMIBC组(P<0.05)。多因素诊断模型预测肌层浸润AUC为0.816,灵敏度为0.788,特异度为0.727,独立危险因素包括TA≥188°、CL≥2.42 cm、CL/C≥0.42。结论 常规超声可作为术前评估膀胱癌肌层侵犯的初筛手段。发现肿瘤TA≥188°、CL≥2.42 cm、CL/C≥0.42时,应警惕肌层浸润性膀胱癌的可能。Objective To explore the role of contact length(CL)and angle between bladder tumor and bladder wall in the prediction of muscle-invasive bladder cancer(MIBC) during routine ultrasound examination. Methods 140 cases with bladder cancer confirmed by pathology were retrospectively analyzed, including 41 cases in MIBC group and 99 cases in non-muscle invasive bladder cancer(NMIBC)group, The differences in ultrasonic characteristics between two groups were compared. Multivariate logistic regression analysis was used to screen the independent risk factors of MIBC and establish a diagnostic model. The receiver operating characteristic(ROC) curve was drawn and calculating the area under the curve(AUC) was calculated to evaluate the diagnostic efficacy of the model in bladder cancer invasiveness. Results Compared with the NMIBC group, the MIBC group showed more frequent multiple and diameter >3 cm(P<0.05). The ratio of lesion diameter, CL, total angle(TA) and contact length/circumference(CL/C) in MIBC group was significantly higher than those in NMIBC group(P<0.05). The multivariate diagnostic model predicted muscle invasion with an AUC of 0.816, a sensitivity of 0.788, and a specificity of 0.727. The independent risk factors included TA≥188 °, CL≥2.42 cm and CL/C≥0.42. Conclusions Conventional ultrasound can be used as a primary screening method for preoperative evaluation of muscle-invasive bladder cancer. When tumors TA≥188°, CL≥2.42 cm, and CL/C≥0.42 are found, the possibility of muscle-invasive bladder cancer should be vigilant.

关 键 词：膀胱肿瘤 肿瘤分期 超声检查 

分 类 号：R737.14[医药卫生—肿瘤] R445.1[医药卫生—临床医学]