CAJ | 학술논문

目的探索膀胱癌患者预后监测的新方法.方法选取病理证实为膀胱尿路上皮癌患者85例.临床分期T(is)～T1期55例,T2～T4期30例;组织学分级G1 27例,G2 40例,G3 18例.膀胱肿瘤电切术后随访1年,每3个月复查.术后第3个月均未复发.术后6个月复发20例,9个月复发18例,术后12个月复发19例,共57例设为复发组.28例术后1年内未复发者设为未复发组.复发组T(is)～T1期35例,T2～T4期22例,未复发组分别为20例,8例.健康对照组50例.应用高效液相色谱/电喷雾-四极杆-飞行时间质谱技术检测各组尿液修饰核苷1-甲基腺苷(M1A)和1-甲基次黄苷(1 -MeI)的水平.统计学比较尿修饰核苷水平与膀胱癌生物学行为的关系.结果术后3个月未复发组尿液修饰核苷水平(M1A:3.24±0.40,1 -M eI:5.73±0.67)明显低于术前(M1 A:4.34±0.98,1-MeI:14.22±4.05,P＜0.005),其后维持在低水平状况.术后3个月复发组(M1A:3.31±0.33,1 -MeI:5.67±0.55)低于术前(M1A:4.32±1.19,1-MeI:14.31±4.12,P＜0.005),其后呈上升趋势并接近术前水平.未复发组和复发组术前尿液修饰核苷水平均高于对照组(M1A:2.91±0.84,1-MeI:5.56±1.25,P＜0.01).复发组术后6、9、12个月尿修饰核苷水平(M1A分别为4.04±0.48、4.11±0.47、4.09±0.53;1-MeI分别为11.46±1.34、12.14±1.22、12.33±1.27)均高于未复发组和对照组(P＜0.01).病理分级间与临床分期间尿液修饰核苷水平差异无统计学意义(P＞0.01).复发组T(is) ～T1期患者尿液修饰核苷水平(M1A:5.92±1.28,1-MeI:20.01±8.53)高于未复发组(M1A:4.02±1.22,1-MeI:11.21±6.45,P＜0.05),T2～T4中亦如此.结论尿液修饰核苷检测对于膀胱癌术后患者预后判断有一定的临床应用价值.
목적 탐색방광암환자예후감측적신방법.방법 선취병리증실위방광뇨로상피암환자85례.림상분기T(is)～T1기55례,T2～T4기30례;조직학분급G1 27례,G2 40례,G3 18례.방광종류전절술후수방1년,매3개월복사.술후제3개월균미복발.술후6개월복발20례,9개월복발18례,술후12개월복발19례,공57례설위복발조.28례술후1년내미복발자설위미복발조.복발조T(is)～T1기35례,T2～T4기22례,미복발조분별위20례,8례.건강대조조50례.응용고효액상색보/전분무-사겁간-비행시간질보기술검측각조뇨액수식핵감1-갑기선감(M1A)화1-갑기차황감(1 -MeI)적수평.통계학비교뇨수식핵감수평여방광암생물학행위적관계.결과 술후3개월미복발조뇨액수식핵감수평(M1A:3.24±0.40,1 -M eI:5.73±0.67)명현저우술전(M1 A:4.34±0.98,1-MeI:14.22±4.05,P＜0.005),기후유지재저수평상황.술후3개월복발조(M1A:3.31±0.33,1 -MeI:5.67±0.55)저우술전(M1A:4.32±1.19,1-MeI:14.31±4.12,P＜0.005),기후정상승추세병접근술전수평.미복발조화복발조술전뇨액수식핵감수평균고우대조조(M1A:2.91±0.84,1-MeI:5.56±1.25,P＜0.01).복발조술후6、9、12개월뇨수식핵감수평(M1A분별위4.04±0.48、4.11±0.47、4.09±0.53;1-MeI분별위11.46±1.34、12.14±1.22、12.33±1.27)균고우미복발조화대조조(P＜0.01).병리분급간여림상분기간뇨액수식핵감수평차이무통계학의의(P＞0.01).복발조T(is) ～T1기환자뇨액수식핵감수평(M1A:5.92±1.28,1-MeI:20.01±8.53)고우미복발조(M1A:4.02±1.22,1-MeI:11.21±6.45,P＜0.05),T2～T4중역여차.결론 뇨액수식핵감검측대우방광암술후환자예후판단유일정적림상응용개치.
Objective To study the application value of modified urine nucleoside's detection in prognosis of patients with bladder cancer. Methods We enrolled 85 patients with bladder transitional cell carcinoma confirmed by pathological examination.The 85 patients fulfilled one-year follow-up visit after TUR-BT and were reviewed every three months.The 85 patients did not relapse in the first third month after operation.At the sixth month after operation,20 cases relapsed.18 cases and 19 cases relapsed at the ninth month and the twelfth month after operation.Patients with recurrence added up to 57 cases as the recurrent group.The remaining 28 cases did not relapse at one year after operation as the no recurrent group.Of the 85 cases,55 cases were in T(is) - T1,while 30 cases were in T2 - T4.Of the 85 cases,27 cases were with G1,40 cases were with G2 and 18 cases were with G3.In T(is) -T1,there were 35 cases in recurrent group,while there were 20 cases in the no recurrent group.In T2 -T4,there were 22 cases in recurrent group,while there were 8 cases in the no recurrent group.There were 50 normal people in the control group.Highperformance liquid chromatography/electrospray ionization-quadrupole-time-of-flight mass spectromerry was used to measure the levels of change of two urine modified nucleosides (M1A,1-MeI) which the patients with bladder cancer had different pathology grades,clinical stages,before or after operation and recurrence or no recurrence. Results The levels at third month after operation in no recurrent group ( M1A:3.24 ± 0.40,1 -MeI:5.73 ± 0.67 ) were significantly lower than that before operation ( M 1A:4.34 ± 0.98,1-MeI:14.22 ± 4.05,P ＜ 0.005 ),and remained in low status at another time points after operation.The levels at the third month after operation in recurrent group (M1A:3.31 ±0.33,1-MeI:5.67 ±0.55) were significantly lower than that before operation ( M1A:4.32 ± 1.19,1-MeI:14.31 ± 4.12,P ＜ 0.005 ),which was on the rise and indicating a high level approaching the condition before operation.According to the time point before the operation,recurrent group and no recurrent group were higher than control group (M1A:2.91 ±0.84,1-MeI:5.56 ± 1.25,P ＜ 0.01 ).The levels at the sixth month,ninth month and twelfth month after operation in recurrent group ( M 1A referring to 4.04 ± 0.48,4.11 ± 0.47,4.09 ± 0.53 ;1-MeI referring to1 1.46 ± 1.34,12.14 ± 1.22,12.33 ± 1.27) were the highest (P ＜ 0.01 ).The levels of change of two urine modified nucleosides between pathology grade and clinical stage had no statistical difference ( P ＞ 0.01 ).The levels in recurrence group in T(is) - T1 ( M1 A:5.92 ± 1.28,1-MeI:20.01 ± 8.53 )were higher than the levels in no recurrent group ( M1A:4.02 ±1.22,1 -MeI:11.21 ± 6.45,P ＜ 0.05 ),which was the same in T2 - T4. Conclusion Urine modified nucleosides detection offer a certain clinical value the prognostic of operated bladder cancer patients.