摘要
目的:探究上尿路上皮癌根治性切除术血糖控制不良者预后的影响因素。方法:选择2015年6月-2018年6月于本院接受根治性切除术的60例上尿路上皮癌患者为研究对象。按照其是否为高血糖患者将其区分为高血糖组(23例)与非高血糖组(37例),比较两组患者临床特征、不同时间局部复发、远处转移情况,而后按照患者随访结局区分为良好组(34例)与不良组(26例),采用单因素与多因素Cox比例风险模型分析影响患者预后的独立风险因素。结果:与非高血糖组相比,高血糖组患者中空腹HDL-C<1.04 mmol/L、并发代谢综合征、临床分期T3~4、淋巴结转移占比明显更高,差异均有统计学意义(P<0.05)。高血糖组术后2年生存率明显高于非高血糖组(P<0.05)。单因素分析发现,空腹TG≥1.7 mmol/L、空腹HDL-C<1.04 mmol/L、高血糖、临床分期T3~4、淋巴结转移与上尿路上皮癌根治性切除术后预后不良有明显的关系(P<0.05)。经多因素Cox分析发现,高血糖、淋巴结转移均是上尿路上皮癌根治性切除术后预后不良的独立危险因素(P<0.05)。结论:血糖控制不良是上尿路上皮癌根治性切除术后患者预后不良的独立危险因素,对此类患者应注意加强临床监控,以预防不良事件发生,改善患者预后。
Objective:To investigate the prognostic factors of patients with poor glycemic control after radical resection of upper urothelial carcinoma.Method:A total of 60 patients with upper urothelial carcinoma who underwent radical resection in our hospital from June 2015 to June 2018 were selected as the research subjects.They were divided into hyperglycemic group(23 cases)and non-hyperglycemic group(37 cases)according to whether they were hyperglycemic patients or not.The clinical characteristics,local recurrence and distant metastasis of two groups were compared,and the patients were divided into good group(34 cases)and bad group(26 cases)according to the follow-up outcome.Univariate and multivariate Cox proportional risk model were used to analyze the independent risk factors affecting the prognosis of patients.Result:Compared with non-hyperglycemia group,the proportion of fasting HDL-C<1.04 mmol/L,complicated metabolic syndrome,clinical stage T3-4 and lymph node metastasis in hyperglycemia group were significantly higher,with statistical significance(P<0.05).The 2-year survival rate in hyperglycemia group was significantly higher than that in non-hyperglycemia group(P<0.05).Single factor analysis showed that fasting TG≥1.7 mmol/L,fasting HDL-C<1.04 mmol/L,hyperglycemia,clinical stage T3-4,lymph node metastasis were significantly associated with poor prognosis after radical resection of upper urothelial carcinoma(P<0.05).Multivariate Cox analysis showed that hyperglycemia and lymph node metastasis were independent risk factors for poor prognosis after radical resection of upper urothelial carcinoma(P<0.05).Conclusion:Poor glycemic control is an independent risk factor for poor prognosis in patients with upper urothelial carcinoma after radical resection.Therefore,attention should be paid to strengthening clinical monitoring for such patients to prevent adverse events and improve the prognosis of patients.
作者
王斌
黎鼎荣
陈存波
林玉龙
WANG Bin;LI Dingrong;CHEN Cunbo;LIN Yulong(The Second Affiliated Hospital of Guangdong Medical University,Zhanjiang 524003,China)
出处
《中国医学创新》
CAS
2021年第9期46-50,共5页
Medical Innovation of China
关键词
上尿路上皮癌
根治性切除术
血糖控制不良
预后不良
相关性
Upper urothelial carcinoma
Radical resection
Poor glycemic control
Poor prognosis
Correlation
