论文部分内容阅读
目的:探讨上尿路移行细胞癌行根治性肾输尿管切除术后出现膀胱内复发的危险因素。方法:回顾性分析我院2005年1月~2012年12月收治的353例行根治性肾输尿管切除术的上尿路移行细胞癌患者病例资料,通过单因素和多因素分析术后出现膀胱复发的相关危险因素。结果:353例患者术后膀胱复发72例(20.4%),平均随访时间39个月,平均复发时间21个月。多因素COX回归分析显示,糖尿病(HR=1.724;95%CI:1.009~2.948;P=0.046)、肿瘤多发(HR=1.852;95%CI:1.043~3.288;P=0.035)和尿脱落细胞阳性(HR=2.075;95%CI:1.225-3.515;P=0.007)是术后膀胱内复发的独立危险因素。结论:糖尿病、肿瘤多发和尿脱落细胞学阳性是上尿路移行细胞癌行根治性肾输尿管切除术后膀胱内复发的独立危险因素,术后应密切随访、积极治疗。
Objective: To investigate the risk factors of intravesical recurrence after radical nephroureterectomy in upper urinary tract transitional cell carcinoma. Methods: The data of 353 patients with upper urinary tract transitional cell carcinoma who underwent radical nephroureterectomy from January 2005 to December 2012 in our hospital were retrospectively analyzed. One-factor and multivariate analysis showed that bladder recurrence occurred Related risk factors. Results: 353 patients had bladder recurrence in 72 patients (20.4%) with an average follow-up time of 39 months and an average recurrence time of 21 months. Multivariate Cox regression analysis showed that the positive rate of urine exfoliated cells was significantly higher in patients with diabetes mellitus (HR = 1.724; 95% CI: 1.009-2.948; P = 0.046), multiple tumor (HR = 1.852; 95% CI: 1.043-3.288; (HR = 2.075; 95% CI: 1.225-3.515; P = 0.007) was an independent risk factor for intravesical recurrence. Conclusions: Diabetes mellitus, multiple tumor and positive urine exfoliative cytology are independent risk factors of intravesical recurrence after radical nephroureterectomy for upper urinary tract transitional cell carcinoma. Postoperative follow-up and active treatment should be performed.