CAJ | 학술논문

目的研究膀胱部分切除术+化疗对盆腔淋巴结阴性的肌层浸润性膀胱癌的治疗效果,报告这一治疗方法的有效性,并探讨影响其预后的因素.方法本研究选取2008年2月至今到本院肿瘤科实行了膀胱部分切除术并联合辅助化疗的肌层浸润性膀胱癌患者的临床有关资料,共纳入50例作为治疗组.同时选取了同一时期接受根治性膀胱切除术治疗的肌层浸润性膀胱癌患者50例作为对照组,并认真收集其临床资料.将治疗组与对照组的有效率进行对比分析.为分析影响盆腔淋巴结阴性的肌层浸润性膀胱癌的危险因素,笔者通过logistic回归进行进一步分析.结果研究所得结果显示治疗组的有效率为87.50％,对照组的有效率为83.33％,两组比较得知,治疗组与对照组在有效率方面并不存在统计学差异(P＞0.05),但通过分期比较,我们所得高选择性患者治疗组的有效率明显高于对照组,且有统计学差异(P＜0.05).logistic回归分析测得病理分级(P=0.001,P＜0.05)和病理分期(P=0.002,P＜0.05)为盆腔淋巴结阴性的肌层浸润性膀胱癌发病的独立危险因素.结论本研究对膀胱部分切除术配合辅助化疗的治疗方法加以对比显示,膀胱部分切除术配合辅助化疗相比根治性膀胱切除术治疗肌层浸润性膀胱癌在所有病理分级中并没有优势,但在高选择性患者中采用膀胱部分切除术配合辅助化疗的治疗方法更有疗效.病理分级和病理分期为影响盆腔淋巴结阴性的肌层浸润性膀胱癌的独立危险因素,应得到充分关注,进而提高盆腔淋巴结阴性的肌层浸润性膀胱癌的预后效果.
목적 연구방광부분절제술+화료대분강림파결음성적기층침윤성방광암적치료효과,보고저일치료방법적유효성,병탐토영향기예후적인소.방법 본연구선취2008년2월지금도본원종류과실행료방광부분절제술병연합보조화료적기층침윤성방광암환자적림상유관자료,공납입50례작위치료조.동시선취료동일시기접수근치성방광절제술치료적기층침윤성방광암환자50례작위대조조,병인진수집기림상자료.장치료조여대조조적유효솔진행대비분석.위분석영향분강림파결음성적기층침윤성방광암적위험인소,필자통과logistic회귀진행진일보분석.결과 연구소득결과현시치료조적유효솔위87.50％,대조조적유효솔위83.33％,량조비교득지,치료조여대조조재유효솔방면병불존재통계학차이(P＞0.05),단통과분기비교,아문소득고선택성환자치료조적유효솔명현고우대조조,차유통계학차이(P＜0.05).logistic회귀분석측득병리분급(P=0.001,P＜0.05)화병리분기(P=0.002,P＜0.05)위분강림파결음성적기층침윤성방광암발병적독립위험인소.결론 본연구대방광부분절제술배합보조화료적치료방법가이대비현시,방광부분절제술배합보조화료상비근치성방광절제술치료기층침윤성방광암재소유병리분급중병몰유우세,단재고선택성환자중채용방광부분절제술배합보조화료적치료방법경유료효.병리분급화병리분기위영향분강림파결음성적기층침윤성방광암적독립위험인소,응득도충분관주,진이제고분강림파결음성적기층침윤성방광암적예후효과.
Objectives To study the treatment effect of bladder resection plus chemotherapy to the muscular layer of pelvic lymph node negative invasive bladder cance,to report the effectiveness of the treatment method and to investigate the prognostic factors.Methods Selecter from February 2008 to our hospital oncology has implemented a muscle invasive bladder cancer partial cystectomy plus adjuvant chemotherapy and clinically relevant information on persons,50 cases were included as a treatment group.To select the same period,while the muscle to accept radical cystectomy for invasive bladder cancer treated 50 cases of people as a control group,and carefully collect clinical data.The treatment group and the control group were analyzed efficiently.Risk factors for analyzing the impact of pelvic lymph node-negative muscle invasive bladder cancer,the authors further analyzed by logistic regression.Results The results showed that the treatment group was the Institute's effective rate of 87.50％,the effective rate was 83.33 ％ in the control group,two groups that the treatment group and the control group do not exist in terms of an efficient statistical difference(P ＞ 0.05) but by staging comparison,we obtained highly selective group of patients was significantly higher efficiency and statistically significant(P ＜ 0.05).Logistic regression analysis was measured pathological grade(P =0.001,P ＜ 0.05) and pathological stage (P =0.002,P ＜ 0.05) were independent risk factors for the pelvic lymph node-negative muscle invasive bladder cancer.Conclusions In this study,partial cystectomy with adjuvant chemotherapy treatments to contrast display,partial resection of bladder surgery adjuvant chemotherapy compared with radical cystectomy treatment of muscle invasive bladder cancer in all pathological grading and no advantage,but the use of the highly selective partial bladder surgery in patients with adjuvant chemotherapy treatments more effective.Pathological grading and staging of pelvic lymph node-negative muscle invasive bladder cancer were independent risk factors should receive adequate attention,thereby improving prognosis of pelvic lymph node-negative muscle invasive bladder cancer.