上尿路尿路上皮癌行根治性肾输尿管切除术后不良病理因素对患者预后影响的文献综述及Meta分析  

Systemic review and meta-analysis of impact of adverse pathological factors on prognosis of patients with upper urinary tract urothelial carcinoma after radical nephroureterectomy

作　　者：蒙绪松 王鹏飞 杨长珉 詹江涛 邓康俐 胡志全[4] 胡鑫明 MENG Xusong;WANG Pengfei;YANG Changmin;ZHAN Jiangtao;DENG Kangli;HU Zhiquan;HU Xinming(Hainan Medical University,Haikou 570100,China;不详)

机构地区：[1]海南医科大学,海口570100 [2]海南医科大学第二附属医院泌尿外科 [3]华中科技大学同济医学院附属湖北肿瘤医院泌尿外科 [4]华中科技大学同济医学院附属同济医院泌尿外科

出　　处：《现代泌尿生殖肿瘤杂志》2025年第2期89-95,100,共8页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的分析根治性肾输尿管全切术(RNU)术后不良病理因素对上尿路上皮癌(UTUC)患者预后生存的影响。方法截止到2023年12月,在Pubmed、Embase、Cochrane Library、CNKI,万方数据库中检索“UTUC、RNU、Overall survival、Cox和Hazard ratio”并筛选出29篇研究进行Meta分析。结果不良病理因素对总生存时间的混合HR分别为pT_(3)~pT_(4)(HR=2.53,95%CI:2.21~2.89,P<0.01),淋巴结阳性(HR=2.02,95%CI:1.79~2.29,P<0.01),肿瘤分级(HR=1.73,95%CI:1.50~2.00,P<0.01),侵犯淋巴结血管(HR=1.73,95%CI:1.50~2.00,P<0.01)。结论不良病理因素与UTUC患者术后总生存时间显著负相关。推荐对具有高危不良病理因素的患者接受辅助化疗治疗以改善预后生存时间。Objective To systematically review the impact of adverse pathological factors(APFs)on the prognosis of partients with upper urinary tract urothelial carcinoma(UTUC)after radical nephroureterectomy(RNU).Methods We searched literature until to December 2023 referring to the keywords"UTUC,RNU,Overall survival(OS),Cox,and Hazard ratio(HR)"in Pubmed,Embase,Cochrane Library,CNKI,and Wanfang datasets.Results The HR of different APFs on OS were as follows:pT_(3)-pT_(4)(HR=2.53,95%CI=2.21,2.89,P<0.01),lymph node involvement(HR=2.02,95%CI=1.79,2.29,P<0.01),tumor grade(HR=1.73,95%CI=1.50,2.00,P<0.01),and lymphovascular invasion(HR=1.73,95%CI=1.50,2.00,P<0.01).Conclusions APFs were significantly negatively correlated with OS in UTUC patients.We recommend to perform adjuvant chemotherapy on patients with high-risk APFs to improve prognostic survival.

关 键 词：上尿路上皮癌 根治性肾输尿管切除术 不良病理因素 总生存期 

分 类 号：R737.1[医药卫生—肿瘤]