摘要
目的探讨上尿路尿路上皮癌(UTUC)患者术后发生膀胱癌的危险因素,为临床预防措施的制定提供参考。方法回顾性分析89例UTUC患者的临床资料,依据术后是否发生膀胱癌分为膀胱癌组和无膀胱癌组,统计2组年龄、性别、体质量指数、手术类型、肿瘤位置等一系列临床资料,先进行单因素分析,之后将具有统计学差异的变量纳入多因素Logistic回归模型,采用逐步回归筛选变量,最终获取UTUC术后发生膀胱癌的独立影响因素。结果 89例UTUC患者,手术治疗后26例发生膀胱癌,术后膀胱癌发生率为29.21%(26/89)。2组性别、年龄、病理分级、肿瘤部位、肿瘤类型、手术类型、肿瘤位置、体质量指数、肿瘤直径及淋巴结阳性情况相比,差异无统计学意义(P>0.05);膀胱癌组在肿瘤分期、术前输尿管镜检术、术前有膀胱癌史方面与无膀胱癌组相比,差异有统计学意义(P<0.05);多因素分析显示:肿瘤分期T;、术前行输尿管镜检术、术前有膀胱癌史是影响UTUC术后发生膀胱癌的高危因素(P<0.05,且OR>1)。结论 UTUC术后存在较高膀胱癌发生率,且肿瘤分期高、术前行输尿管镜检术及术前有膀胱癌史为膀胱癌发生的高危因素,临床应做好术前评估,并重点关注高危因素,针对性予以预防措施,以降低术后膀胱癌发生风险。
Objective To investigate the risk factors of postoperative bladder cancer in patients with upper urinary tract urothelial carcinoma(UTUC),and to provide important reference for the formulation of clinical preventive measures.Methods Clinical data of 89 patients with UTUC were retrospectively analyzed.According to whether bladder cancer was divided into bladder cancer group and bladder cancer group, a series of clinical data of 2 groups were collected, including age, gender, body mass index, type of operation and tumor location.The univariate analysis was performed first, and then the variables with statistical difference were included in the multivariate Logistic regression model.Stepwise regression was used to screen variables, and finally independent factors affecting bladder cancer after UTUC were obtained.Results 89 UTUC patients, 26 patients developed bladder cancer after operation, and the incidence of bladder cancer was 29.21%(26/89) after operation.There was no significant difference between the 2 groups in gender, age, pathological grade, tumor location, tumor type, operation type, tumor location, body mass index, tumor diameter and lymph node positivity(P>0.05);There were significant differences in tumor staging, preoperative ureteroscopy and preoperative bladder cancer between bladder cancer group and non bladder cancer group(P<0.05).Multivariate analysis showed that tumor stage T;,preoperative ureteroscopy, and preoperative bladder cancer history were the risk factors for bladder cancer after UTUC(P<0.05,and OR>1).Conclusion There is a higher incidence of bladder cancer after UTUC.High tumor stage, preoperative ureteroscopy and preoperative history of bladder cancer are the risk factors for bladder cancer.Preoperative evaluation should be done well, and high risk factors should be paid attention to, and preventive measures should be taken to reduce the risk of bladder cancer after operation.
作者
苗培培
陈路
吴婷
肖瑶
李运芳
MIAO Peipei;CHEN Lu;WU Ting(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000)
出处
《实用癌症杂志》
2022年第2期312-314,共3页
The Practical Journal of Cancer
基金
河南省医学科技攻关计划项目(编号:2018112562)。
