中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
17期
29-31
,共3页
刘硕%苗文隆%李凤歧%王哲%孙光
劉碩%苗文隆%李鳳歧%王哲%孫光
류석%묘문륭%리봉기%왕철%손광
输尿管肿瘤%复发%膀胱肿瘤%上尿路移行上皮细胞癌
輸尿管腫瘤%複髮%膀胱腫瘤%上尿路移行上皮細胞癌
수뇨관종류%복발%방광종류%상뇨로이행상피세포암
Ureteral neoplasms%Recurrence%Bladder neoplasms%Upper urinary tract transitional cell arcinoma
目的 探讨肿瘤部位与上尿路移行上皮细胞癌根治术后复发膀胱肿瘤风险的关系.方法 对行根治手术并获随访的168例上尿路移行上皮细胞癌患者的临床资料进行回顾性总结,比较不同部位上尿路移行上皮细胞癌根治术后复发膀胱肿瘤的风险,采用Cox回归分析术后复发膀胱肿瘤风险的独立影响因素.结果 168例患者术后1、3、5年的无复发膀胱肿瘤的生存率分别为88%、76%和63%.观察期内,共有49例术后发生膀胱肿瘤复发,中位首次复发时间为20个月.肾盂癌术后复发率为30.8%(28/91);输尿管中段癌术后复发率为8.3%(2/24),输尿管下段癌术后复发率为48.7%(19/39).肾盂癌与输尿管癌患者术后无复发膀胱肿瘤生存率比较差异无统计学意义(P>0.05).多因素分析结果显示输尿管下段癌为影响上尿路移行上皮细胞癌根治术后复发膀胱肿瘤风险的独立变量(P<0.01).结论 输尿管下段癌患者术后复发膀胱肿瘤的风险高于其他部位上尿路移行上皮细胞癌.
目的 探討腫瘤部位與上尿路移行上皮細胞癌根治術後複髮膀胱腫瘤風險的關繫.方法 對行根治手術併穫隨訪的168例上尿路移行上皮細胞癌患者的臨床資料進行迴顧性總結,比較不同部位上尿路移行上皮細胞癌根治術後複髮膀胱腫瘤的風險,採用Cox迴歸分析術後複髮膀胱腫瘤風險的獨立影響因素.結果 168例患者術後1、3、5年的無複髮膀胱腫瘤的生存率分彆為88%、76%和63%.觀察期內,共有49例術後髮生膀胱腫瘤複髮,中位首次複髮時間為20箇月.腎盂癌術後複髮率為30.8%(28/91);輸尿管中段癌術後複髮率為8.3%(2/24),輸尿管下段癌術後複髮率為48.7%(19/39).腎盂癌與輸尿管癌患者術後無複髮膀胱腫瘤生存率比較差異無統計學意義(P>0.05).多因素分析結果顯示輸尿管下段癌為影響上尿路移行上皮細胞癌根治術後複髮膀胱腫瘤風險的獨立變量(P<0.01).結論 輸尿管下段癌患者術後複髮膀胱腫瘤的風險高于其他部位上尿路移行上皮細胞癌.
목적 탐토종류부위여상뇨로이행상피세포암근치술후복발방광종류풍험적관계.방법 대행근치수술병획수방적168례상뇨로이행상피세포암환자적림상자료진행회고성총결,비교불동부위상뇨로이행상피세포암근치술후복발방광종류적풍험,채용Cox회귀분석술후복발방광종류풍험적독립영향인소.결과 168례환자술후1、3、5년적무복발방광종류적생존솔분별위88%、76%화63%.관찰기내,공유49례술후발생방광종류복발,중위수차복발시간위20개월.신우암술후복발솔위30.8%(28/91);수뇨관중단암술후복발솔위8.3%(2/24),수뇨관하단암술후복발솔위48.7%(19/39).신우암여수뇨관암환자술후무복발방광종류생존솔비교차이무통계학의의(P>0.05).다인소분석결과현시수뇨관하단암위영향상뇨로이행상피세포암근치술후복발방광종류풍험적독립변량(P<0.01).결론 수뇨관하단암환자술후복발방광종류적풍험고우기타부위상뇨로이행상피세포암.
Objective To investigate the relationship between tumor location and the risk of developing bladder cancer in pafients treated by nephroureterectomy(NU)for upper urinary tract transitional cell carcinoma(UUT-TCC).Methods The clinical data of 168 UUT-TCC patients who underwent NU were reviewed.Univariate and multivariate analysis were carried out to determine the risk factors for intravesical recurrence after NU.Results The recurrence-free survival rate at 1,3 and 5 years after NU were 88%, 76%and 63%.All patients were followed up for a median period of 45(12-107)months During this period, a total of 49 patients developed bladder tamors after surgery,of which 28 cases were renal pelvic carcinoma, 2 cases were rniddle ureter carcinoma and 19 cases were distal ureter carcinoma.The recurrence-free survival of renal pelvic carcinoma and ureter carcinoma had no significant difference by Log-Rank test(P>0.05).On multivariate analysis,only locating in distal ureter carcinoma was the independent risk predictor for intravesical recurrence after NU (P<0.01).Conclusion Pafients with UUT-TCC at distal ureter carry a higher risk for intraeesieal recunerrce after NU than those with TCC at other location of upper urinary tract.
