经尿道膀胱肿瘤电切术后病理分期升级预测因素分析

瞿根义; 吴宇鹏; 许宁; 陈少豪; 林云知; 黄金杯; 魏勇; 郑清水; 薛学义

doi:10.13201/j.issn.1001-1420.2017.10.007

经尿道膀胱肿瘤电切术后病理分期升级预测因素分析

- 1. 福建医科大学附属第一医院泌尿外科(福州, 350005);
- 2. 株洲市中心医院泌尿外科

详细信息

通讯作者: 薛学义,E-mail:xuexueyi@fjmu.edu.cn

中图分类号: R737.14

收稿日期: 2017-08-10

Predictors of pathological upstaging after transurethral resection of bladder tumor

- 1. Department of Urology, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China;
- 2. Department of Urology, Zhuzhou Central Hospital

More Information

Corresponding author: XUE Xueyi, E-mail: xuexueyi@fjmu.edu.cn

Received Date: 10 August 2017

摘要

摘要: 目的：探讨经尿道膀胱肿瘤电切术术前临床分期评估的准确性及预测术后病理分期变化预测因素。方法：收集2010年1月~2014年1月我院258例行经尿道膀胱肿瘤切除术患者的临床病例资料，包括患者年龄、性别、肾积水情况、尿脱落细胞学、双合诊结果、既往膀胱癌病史、术前临床分期和术后病理分期等。比较术前临床分期与术后病理分期差别，Logistic回归分析膀胱癌术后病理分期升级与降级的影响因素。结果：术前临床分期与术后病理学分期一致的共224例（86.8%），34例（13.2%）存在差异（29例出现术后病理分期升级，5例出现术后病理分期降级）。多因素Logistic回归分析提示双合诊中触及明显肿块的是术后病理分期上调的预测因子（95% CI：2.25~58.21，OR=11.43，P<0.01）。结论：膀胱癌术前临床分期与术后病理分期准确性高，术前双合诊是术后病理分期升级的独立预测因素。
- 膀胱癌 /
- 经尿道膀胱肿瘤电切术 /
- 临床分期 /
- 病理分期
Abstract: Objective: To determine the accuracy of clinical stage after transurethral resection of bladder tumor and to identify factors predicting the discrepancy between clinical stage and pathological stage.Method: We retrospectively reviewed 258 patients who underwent transurethral resection of bladder tumor from January 2010 to January 2014.Clinicopathological characteristics were collected to compare the difference between clinical stage and pathological stage.Logistic regression analysis was performed to determine predictors of pathological upstaging.Result: The concordance rate was 86.8% (224/258) between clinical stage and pathological stage.Stage was upgraded in 29 patients and was downgraded in 5 patients.Multivariate logistic regression analysis indicated that the presence of a palpable mass in the bimanual examination was a predictor of pathological upstaging (P<0.01, OR=11.43, 95%CI:2.25-58.21).Conclusion: This study demonstrated the high accuracy between clinical and pathological stage.A palpable mass in the bimanual examination was an independent predictor of pathological upstaging.
- bladder cancer /
- transurethral resection of bladder tumor /
- clinical stage /
- pathological stage

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参考文献(13)

[1]	Babjuk M, Böhle A, Burger M, et al.EAU Guidelines on Non-Muscle-invasive Urothelial Carcinoma of the Bladder:Update 2016[J].Eur Urol, 2017, 71 (3):447-461.
[2]	易善红.我国膀胱癌诊治指南解读[J].中华临床医师杂志 (电子版), 2013, 7 (3):924-925.
[3]	Witjes J A, Comperat E, Cowan N C, et al.EAU guidelines on muscle-invasive and metastatic bladder cancer:summary of the 2013guidelines[J].Eur Urol, 2014, 65 (4):778-792.
[4]	Mashni J, Godoy G, Haarer C, et al.Prospective evaluation of plasma kinetic bipolar resection of bladder cancer:comparison to monopolar resection and pathologic findings[J].Int Urol Nephrol, 2014, 46 (9):1699-1705.
[5]	Gray P J, Lin C C, Jemal A, et al.Clinical-pathologic stage discrepancy in bladder cancer patients treated with radical cystectomy:results from the national cancer data base[J].Int J Radiat Oncol Biol Phys, 2014, 88 (5):1048-1056.
[6]	Svatek R S, Shariat S F, Novara G, et al.Discrepancy between clinical and pathological stage:external validation of the impact on prognosis in an international radical cystectomy cohort[J].BJU Int, 2011, 107 (6):898-904.
[7]	曹明, 赵宏, 穆鑫, 等.吉西他滨联合顺铂方案新辅助化疗联合全膀胱切除术治疗肌层浸润性膀胱癌的9年回顾性分析[J].中华泌尿外科杂志, 2014, 35 (1):49-53.
[8]	刘明, 闫伟, 于京赢, 等.CT对膀胱癌局部分期的准确性及影响因素分析[J].临床泌尿外科杂志, 2009, 24 (6):439-441.
[9]	那彦群, 章群, 孙颖浩, 等.中国泌尿外科疾病诊断治疗指南 (2014版)[M].北京:人民卫生出版社, 2014:24-33.
[10]	邢金春, 张开颜, 叶章群, 等.膀胱肿瘤术前活检和术后标本病理分级差异性分析[J].现代泌尿生殖肿瘤杂志, 2009, 1 (3):140-145.
[11]	Gore J L, Lai J, Setodji C M, et al.Mortality increases when radical cystectomy is delayed more than 12weeks:results from a Surveillance, Epidemiology, and End Results-Medicare analysis[J].Cancer, 2009, 115 (5):988-996.
[12]	Power N E, Izawa J.Comparison of Guidelines on NonMuscle Invasive Bladder Cancer (EAU, CUA, AUA, NCCN, NICE)[J].Bladder Cancer, 2016, 2 (1):27-36.
[13]	Mehrsai A, Mansoori D, TaheriMahmoudi M, et al.Acomparison between clinical and pathologic staging in patients with bladder cancer[J].Urol J, 2004, 1 (2):85-89.