论文部分内容阅读
目的探讨代谢综合征(MS)与其分组对T1期高级别膀胱癌患者生存状况的影响。方法选取2010年6月至2015年12月期间于我院首次确诊并行经尿道膀胱肿瘤切除术的169例原发性T1期高级别膀胱癌患者为研究对象,并分为MS组(n=19)与非MS组(n=150),肥胖组(n=83)与非肥胖组(n=86),高血压组(n=60)与非高血压组(n=109),糖尿病(DM)组(n=35)与非DM组(n=134),高血脂组(n=29)与非高血脂组(n=140)。比较各组的复发率、进展率、无复发生存期(RFS)与无疾病进展生存期(PFS),采用单因素Cox比例风险模型对MS及各个组分与预后的关系进行分析。结果全部患者均进行了术后随访7~69个月,中位随访时间为33.2个月,有105例(62.1%)出现肿瘤复发,72例(42.6%)出现肿瘤进展,平均RFS与PFS分别为27.18个月和38.06个月。MS组的进展率显著高于非MS组,肥胖组的复发率和进展率均显著高于非肥胖组,DM组的复发率和进展率均显著高于非DM组,差异有统计学意义(P<0.05)。MS组的平均RFS与PFS显著低于非MS组,肥胖组的平均RFS与PFS显著低于非肥胖组,DM组的平均RFS与PFS显著低于非DM组,差异有统计学意义(P<0.05)。单因素Cox比例风险模型结果表明肥胖与DM均可增加患者肿瘤复发和进展的风险(P<0.05),而MS、高血压、高血脂与患者术后复发与进展的风险均无显著相关性(P>0.05)。结论肥胖、糖尿病可增加T1期高级别膀胱癌患者术后复发、进展的风险,而MS、高血压、高血脂与患者的生存状况无显著相关性。
Objective To investigate the influence of metabolic syndrome (MS) and its subgroups on the survival of high-grade T1 bladder cancer patients. Methods Sixty-nine patients with primary T1 stage high-grade bladder cancer who underwent transurethral resection of the bladder in our hospital for the first time between June 2010 and December 2015 were selected as study subjects and divided into MS group (n = 19) (N = 60), non-MS group (n = 150), obesity group (n = 83) and non-obesity group (N = 35) and non-DM group (n = 134), hyperlipemia group (n = 29) and non-hyperlipidemia group (n = 140). The recurrence rate, progression rate, recurrence-free survival (RFS) and disease-free survival (PFS) were compared between groups. The relationship between MS and its prognosis was analyzed by single factor Cox proportional hazard model. Results All patients were followed up for 7 to 69 months. The median follow-up time was 33.2 months. Tumor recurrence occurred in 105 (62.1%) and tumor progression in 72 (42.6%) patients. The mean RFS and PFS 27.18 months and 38.06 months. The progression rate of MS group was significantly higher than that of non-MS group. The relapse rate and progression rate of obesity group were significantly higher than those of non-obese group. The recurrence rate and progression rate of DM group were significantly higher than those of non-DM group P <0.05). The average RFS and PFS in MS group were significantly lower than those in non-MS group. The average RFS and PFS in obese group were significantly lower than those in non-obese group. The mean RFS and PFS in DM group were significantly lower than those in non-DM group (P < 0.05). The results of univariate Cox proportional hazards model showed that both obesity and DM increased the risk of tumor recurrence and progression (P <0.05), but there was no significant correlation between MS, hypertension and hyperlipemia in patients with postoperative recurrence and progression P> 0.05). Conclusion Obese and diabetes can increase the recurrence and progression risk of patients with stage T1 high grade bladder cancer, while MS, hypertension and hyperlipidemia have no significant correlation with the survival of patients.