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目的研究影响肌层浸润性膀胱移行细胞癌患者预后相关因素。方法回顾性分析102例肌层浸润性膀胱移行细胞癌患者的临床病理以及完整随访资料,分析因素包括患者性别、年龄、合并慢性病、肾积水、肿瘤多灶性、瘤体大小、T分期、淋巴结是否转移、肿瘤组织分化程度和治疗方法,采用Kaplan-Meier法计算总生存率,采用Log-rank检验进行单因素分析,用Cox模型进行多因素分析。结果随访期为4~119个月,全部患者1、3、5年总生存率分别为78.3%、65.2%、52.9%,中位生存期为62个月。单因素分析显示不同T分期、淋巴结是否转移、不同肿瘤组织分化程度及有无肾积水患者预后差异有统计学意义(P﹤0.05)。Cox多因素分析显示,合并慢性病(RR=2.068,P=0.026)和肾积水(RR=3.218,P=0.002)是影响局部肌层浸润性移行细胞膀胱癌患者预后的独立因素。结论 T分期、淋巴结转移情况、肿瘤组织分化程度及肾积水是局部肌层浸润性膀胱移行细胞癌患者预后相关因素,而合并症及肾积水是预后的独立影响因素。
Objective To study the prognostic factors that affect the prognosis of mycotic invasive bladder transitional cell carcinoma. Methods A retrospective analysis of 102 cases of invasive muscle transitional cell carcinoma of the bladder in patients with clinical pathology and complete follow-up data, analysis of factors including gender, age, with chronic disease, hydronephrosis, tumor multifocal, tumor size, T stage, Lymph node metastasis, tumor differentiation and treatment methods, using Kaplan-Meier method to calculate the overall survival rate, using Log-rank test for univariate analysis, Cox model for multivariate analysis. Results The follow-up period ranged from 4 to 119 months. The overall 1,3,5-year overall survival rates of patients were 78.3%, 65.2% and 52.9%, respectively. The median survival time was 62 months. Univariate analysis showed different T stage, lymph node metastasis, tumor differentiation and prognosis of patients with or without hydronephrosis have statistical significance (P <0.05). Cox multivariate analysis showed that the combination of chronic diseases (RR = 2.068, P = 0.026) and hydronephrosis (RR = 3.218, P = 0.002) were independent prognostic factors for locally mycotic invasive bladder transitional cell carcinoma. Conclusion T stage, lymph node metastasis, tumor differentiation and hydronephrosis are prognostic factors in patients with locally mycotic invasive bladder transitional cell carcinoma. Complications and hydronephrosis are independent prognostic factors.