输尿管移行细胞癌预后影响因素分析

Prognostic factors of ureteral transitional cell carcinoma

目的提高输尿管移行细胞癌的治疗效果。方法对获随访的３５例输尿管移行细胞癌预后影响因素作回顾性分析。结果输尿管肿瘤３年生存率为５４％，５年生存率为４６％，单发输尿管上中段癌３年、５年生存率分别为８６％和８６％，明显高于下段癌的４３％和２９％（Ｐ＜０．０５）。细胞分级：Ｇ１４例无１例死亡；Ｇ３３年、５年生存率分别为３１％和２３％，明显低于Ｇ２的６６％和５０％（Ｐ＜０．０１）。以临床分期统计其３年、５年生存率：Ｔ１１００％和８３％；Ｔ２６５％和５５％（Ｐ＞０．０５）；Ｔ３均于３年内死亡。结论输尿管移行细胞癌预后差，输尿管下段癌预后最差，肿瘤细胞分化程度及浸润深度是决定预后的主要因素。

bjective To probe into the prognostic factors of ureteral transitional cell carcinoma. Methods 35 cases of ureteral transitional cell carcinoma have been followed up and reviewed.The prognostic factors were analyzed. Results The overall 3 year survival rate has been 54% and the 5 year survival rate 46%.For monofocal carcinoma of the upper and middle segments of the ureter,the 3 year and the 5 year survival rate were 86% and 86% respectively,being significantly higher than those of the lower segment ureteral carcinoma (43% and 29%,P<0.05).The 3 year and 5 year survival rate of G1 tumors were both 100%,while those of G3 tumors were 31% and 23%,being significantly lower than those of G2 tumors (66% and 50%,P<0.01).The 3 year and 5 year survival rate of T1 tumors were 100% and 83% while those of T2 tumors were 65% and 55% (P<0.05).The 3 year survival rate of T3 tumors was 0%. Conclusions The prognosis of ureteral transitional cell carcinoma is usually poor especially the lower segment ureteral carcinoma.The grade of cell differentiation and the depth of tumor infiltration are the most determinant prognostic factors.