Feasibility of preoperative routine urine testing for predicting the staging of urinary tract carcinoma with diagnostic TURBT
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摘要: 目的 探讨术前尿常规检测中尿比重、pH值、高倍镜下白细胞计数(white blood cell count at high power field，WBC/HPF)、高倍镜下红细胞计数(red blood cell count at high power field，RBC/HPF)对于初发膀胱尿路上皮癌患者肿瘤分级的预测价值。方法 选取海军军医大学第一附属医院2021年7月—2022年8月收治的203例拟行诊断性经尿道膀胱肿瘤电切术(transurethral resection of bladder tumor，TURBT)治疗的初发膀胱癌患者，收集患者术前的尿常规检测数据，按中位数分为低尿比重组(< 1.018)与高尿比重组(≥1.018)、低pH值组(< 6)与高pH值组(≥6)、低WBC/HPF组(< 2.1)与高WBC/HPF组(≥2.1)、低RBC/HPF组(< 6.4)与高RBC/HPF组(≥6.4)。结果 术前高龄患者尿比重更低(P < 0.05)。术前尿液高WBC/HPF与主诉、病理分级密切相关(P < 0.05)。术前尿液高RBC/HPF与年龄、主诉、肿瘤病理分级密切相关(P < 0.05)。结论 术前尿常规中WBC/HPF、RBC/HPF与初发膀胱尿路上皮癌患者肿瘤不良病理分级相关，可作为患者病理分级的预测指标。Abstract: Objective To investigate the proportion of urine, pH value, white blood cell count at high power field(WBC/HPF) and red blood cell count at high power field(RBC/HPF) in predicting tumor grade in patients with primary bladder uroepithelial carcinoma.Methods Two hundred and three transurethral resection of bladder tumor(TURBT) patients with primary bladder cancer who were treated at the First Hospital Affiliated to Naval Medical University from July 2021 to August 2022 were selected. Preoperative urine routine test data of patients were collected. They were divided into low urine ratio recombination(< 1.018) and high urine ratio recombination(≥1.018), low pH group(< 6) and high pH group(≥6), low WBC/HPF group(< 2.1) and high WBC/HPF group(≥2.1), low RBC/HPF group(< 6.4) and high RBC/HPF group(≥6.4).Results The older patients had lower urinary specific gravity before surgery(P < 0.05). Preoperative high urine WBC/HPF was closely correlated with chief complaint and pathological grade(P < 0.05). Preoperative high urine RBC/HPF was closely related to age, chief complaint and tumor pathological grade(P < 0.05).Conclusion WBC/HPF and RBC/HPF in preoperative urine routine are correlated with the pathological grade of neoplasm in patients with primary bladder uroepithelial carcinoma, so they can be used as predictors of the pathological grade of patients.
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表 1 尿比重、pH值、WBC/HPF、RBC/HPF与膀胱癌患者的临床资料
例，X±S 项目 例数 尿比重 pH值 < 1.018(99例) ≥1.018(104例) P值 < 6(60例) ≥6(143例) P值 年龄/岁 66.1±12.5 61.3±12.6 0.007 62.8±13.1 63.9±12.6 0.575 BMI/(kg/m2) 23.8±3.3 24.6±2.9 0.061 24.5±3.1 24.2±3.1 0.486 性别 0.248 0.531 男 171 80 91 49 122 女 32 19 13 11 21 合并慢性病 0.575 0.645 是 94 48 46 26 68 否 109 51 58 34 75 主诉 0.305 0.262 膀胱占位 72 39 33 25 47 血尿 131 60 71 35 96 住院天数/d 0.776 0.640 < 3 85 40 45 27 58 ≥4 118 59 59 33 85 病理分级 0.141 0.126 PUNLMP+UCCLG 101 44 57 35 66 UCC-HG 102 55 47 25 77 项目 例数 WBC/HPF RBC/HPF < 2.1(99例) ≥2.1(104例) P值 < 6.4(101例) ≥6.4(102例) P值 年龄/岁 62.5±13.5 64.7±11.9 0.209 61.8±13.8 65.4±11.3 0.047 BMI/(kg/m2) 24.2±3.2 24.3±3.0 0.820 24.4±2.9 24.1±3.2 0.529 性别 0.879 0.127 男 171 83 88 81 90 女 32 16 16 20 12 合并慢性病 0.482 0.888 是 94 43 51 46 48 否 109 56 53 55 54 主诉 0.005 0.001 膀胱占位 72 45 27 53 19 血尿 131 54 77 48 83 住院天数/d 0.323 0.478 < 3 85 45 40 45 40 ≥4 118 54 64 56 62 病理分级 0.001 0.003 PUNLMP+UCCLG 101 61 40 61 40 UCC-HG 102 38 64 40 62 
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