肿瘤位置对接受经尿道膀胱肿瘤切除术的非肌层浸润性膀胱癌患者预后的影响  

Prognostic impact of tumor location in non-muscle-invasive bladder cancer patients undergoing transurethral resection of bladder tumor

作　　者：宋利 杜义恒 王博[2] 戴以恒 刘毅铮[2] SONG Li;DU Yi-heng;WANG Bo(Department of Breast Radiotherapy,Jiamusi City Cancer Hospital,Jiamusi Heilongjiang 154000,China;Department of Urology,Suzhou Kowloon Hospital,School of Medicine,Shanghai Jiao Tong University,Suzhou Jiangsu 215000,China)

机构地区：[1]佳木斯市肿瘤医院乳腺放疗科,黑龙江佳木斯154000 [2]上海交通大学医学院苏州九龙医院泌尿外科,江苏苏州215000

出　　处：《临床和实验医学杂志》2025年第5期546-549,共4页Journal of Clinical and Experimental Medicine

基　　金：黑龙江省卫生健康委科研课题(编号:20230909030187)。

摘　　要：目的探讨肿瘤部位对接受经尿道膀胱肿瘤切除术(TURBT)治疗的非肌层浸润性膀胱癌(NMIBC)患者预后的影响。方法将2017年1月至2022年1月上海交通大学医学院苏州九龙医院收治的初次诊断为NMIBC并接受TURBT的患者纳入本次回顾性研究。记录不同肿瘤部位(侧壁、前壁、膀胱颈、穹窿、交搭跨越、后壁、三角区、脐尿管和输尿管口)患者的肿瘤位置、年龄、性别、肿瘤数量、T分期、Grade分级(低、高和未知)、组织学类型、化疗情况、肿瘤大小和患者预后[总生存期(OS)和无进展生存期(PFS)]。采用Kaplan-Meier生存曲线、Cox回归分析探讨肿瘤部位与预后之间的关系。结果本研究共计纳入100例NMIBC患者,其中以侧壁、交搭跨越肿瘤为主。不同肿瘤位置患者的的年龄、性别和化疗情况比较,差异均无统计学意义(P>0.05),而肿瘤数量和大小、T分期、Grade分级和组织学类型比较,差异均有统计学意义(P<0.05)。Kaplan-Meier生存曲线显示肿瘤部位是影响TURBT后NMIBC患者预后的关键因素。单因素及多因素COX回归分析发现,患者年龄、肿瘤位于前壁或穹窿、肿瘤数目、T分期、Grade分级均是患者OS较差的独立危险因素(P<0.05)。肿瘤位于膀胱前壁或穹窿的患者预后较膀胱侧壁患者更差:前壁肿瘤(OS的风险比=4.40,95%CI:2.49~7.87,P<0.001);膀胱穹窿(OS的风险比=7.97,95%CI:4.88~12.96,P<0.001)。结论NMIBC患者肿瘤部位对TURBT治疗结果的显著影响,位于前壁和膀胱穹窿的肿瘤TURBT后预后较差。Objective To investigate the effect of tumor location on the prognosis of non-muscle-invasive bladder cancer(NMIBC)patients undergoing transurethral resection of bladder tumor(TURBT).Methods Patients initially diagnosed with NMIBC and undergoing TURBT admitted to Suzhou Kowloon Hospital,School of Medicine,Shanghai Jiao Tong University from January 2017 to January 2022 were included in this retrospective study.The tumor location,age,sex,number of tumors,T stage,Grade grade,histological type,chemotherapy,tumor size and prognosis[overall survival(OS)and progression free survival(PFS)]of patients with different tumor sites were recorded.Kaplan-Meier,and Cox regression analysis were employed to explore the association between tumor location and prognosis.Results This study included 100 NMIBC patients and the main ones were lateral walls and overlapping crossing tumors.There were no statistically significant differences in age,gender and chemotherapy among patients with different tumor locations(P>0.05),while there were statistically significant differences in tumor number and size,T stage,Grade classification and histological type(P<0.05).Kaplan Meier survival curve showed that tumor location was a crucial factor impacting post-TURBT prognosis.Univariate and multivariate COX regression analysis showed that age,tumor location in the anterior wall or fornix,number of tumors,T stage and Grade were independent risk factors for poor OS(P<0.05).For anterior wall tumors,hazard ratios of OS was 4.40(95%CI:2.49-7.87,P<0.001).Dome tumors displayed hazard ratios of OS was 7.97(95%CI:4.88~12.96,P<0.001).Conclusion This study reveals the significant impact of tumor location in NMIBC patients on the outcomes of TURBT treatment,with tumors in the anterior wall and bladder dome showing poor post-TURBT prognosis.

关 键 词：膀胱切除术 预后 肿瘤位置 非肌层浸润性膀胱癌 

分 类 号：R737.14[医药卫生—肿瘤]