CAJ | 학술논문

目的：探讨病理亚分期在T1 G3膀胱尿路上皮癌患者预后评价中的意义以及T1me （ T1-微浸润和T1-广泛浸润）亚分期系统作为T1 G3患者亚分期方法的可行性。方法选择原发T1 G3膀胱尿路上皮癌患者87例，其中56例患者的基础资料、病理阅片及随访完整。按照T1me分期法，将56例T1G3膀胱尿路上皮癌患者经尿道膀胱肿瘤电切术后获得的病理标本分为T1m期17例（A组）和T1e期39例（ B组），然后分析患者的预后情况。基础资料比较采用χ2检验，5年无复发生存率、5年无进展生存率比较采用Kaplan-Meier生存分析及Log-rank检验。结果两组患者年龄、肿瘤大小、是否多发、膀胱灌注治疗等方面比较差异均无统计学意义（P＞0．05）。5年无复发生存率（P＝0．037）、5年无进展生存率（P＝0．045）比较差异均有统计学意义，T1m期患者预后优于T1e期患者。结论病理亚分期是判断原发T1 G3膀胱尿路上皮癌患者预后的重要因素。 T1me分期法作为T1 G3膀胱尿路上皮癌病理亚分期的分期方法客观、实用、易行。
목적：탐토병리아분기재T1 G3방광뇨로상피암환자예후평개중적의의이급T1me （ T1-미침윤화T1-엄범침윤）아분기계통작위T1 G3환자아분기방법적가행성。방법선택원발T1 G3방광뇨로상피암환자87례，기중56례환자적기출자료、병리열편급수방완정。안조T1me분기법，장56례T1G3방광뇨로상피암환자경뇨도방광종류전절술후획득적병리표본분위T1m기17례（A조）화T1e기39례（ B조），연후분석환자적예후정황。기출자료비교채용χ2검험，5년무복발생존솔、5년무진전생존솔비교채용Kaplan-Meier생존분석급Log-rank검험。결과량조환자년령、종류대소、시부다발、방광관주치료등방면비교차이균무통계학의의（P＞0．05）。5년무복발생존솔（P＝0．037）、5년무진전생존솔（P＝0．045）비교차이균유통계학의의，T1m기환자예후우우T1e기환자。결론병리아분기시판단원발T1 G3방광뇨로상피암환자예후적중요인소。 T1me분기법작위T1 G3방광뇨로상피암병리아분기적분기방법객관、실용、역행。
Objective To evaluate the impact of sub-stage on the clinical prognosis of T 1 G3 and evaluate the feasibility of the T1me system in pT1G3 sub-staging.Methods The clinical data,pathological specimen and follow-up data were collected from 56 patients out of 87 patients diagnosed with initial high-grade T1 bladder urothelial carcinoma .The patients were divided into Group A [ T1-microinvasive (T1m),17 cases] and group B [T1-extensive-invasive (T1e),39 cases] according to pathological evaluation after transurethral resection.Clinical parameters were analyzed with Chi-square test,and recurrence-free and progression free survival were obtained by Kaplan-Meier analysis and Log-rank test.Results Age,tumor size,number and intravesical instilled medication showed no significant differences between the 2 groups ( P>0.05 ) .There were significant differences of 5-year recurrence-free rate ( P =0.037 ) and progression-free survival rate ( P =0.045 ) between the 2 groups, and the prognosis of group A was significantly better than that of group B .Conclusion The pathological sub-stage is an important predictor in initial high-grade T1 bladder urothelial carcinoma patients , and the T1me system is objective and feasible.