输尿管癌手术预后的临床病理多因素分析

Multivariate Analysis of Clinicopathological Factors on Ureter Transitional Cell Carcinoma

目的综合分析和评价临床病理因素对输尿管癌手术预后的影响。方法对手术切除51例输尿管癌7个临床病理因素进行单因素和多因素Cox模型分析。结果单因素分析表明:年龄(P=0.000)、临床分期(P=0.004)、组织学分级(P=0.000)及手术方式(P=0.048)与输尿管癌手术预后显著相关;性别(P=0.655)、肿瘤部位(P=0.245)及病理分级(P=0.092)与输尿管癌手术预后无关。多因素分析表明:临床分期(P=0.021)、组织学分级(P=0.001)、病理分级(P=0.048)及手术方式(P=0.039)是影响输尿管癌手术预后最显著的独立因素。结论在输尿管癌手术术式设计和选择上,更应该重视和强调根治术,在对输尿管癌术后患者预后评估及术后治疗更应该参考临床分期、组织学分级及病理分级。

Objective Our purpose was to evaluate the influence of various clinicopathologic factors on the survival of patients with ureter transitional cell carcinoma（TCC）. Methods A computer analysis was performed on 51 patients underwent TCC resection. Results Univariate analysis identified 7 factors that were associated with a significant outcome： Age （P=0.000） , clinical stage （P=0.004） , histologic type of lesion （P=0.000） and the way of surgical operation （P=0.048）. The gender （P=0.655） , location of primary lesion （P=-0.245） and pathology type of lesion （P=0.092） were not significantly associated with prognosis. However, when the interactive effects of these factors were taken into account,the clinical stage （P=0.021） , histologic type of lesion （P=0.001） ,pathology type of lesion （P=0.048） and way of surgical operation （P=0.039） were selected as the most significant prognostic factors in a multivariate analysis by using the Cox proportional hazard regression model. Conclusion In ureteral cancer surgery procedures design and choice, more importance should be attached to radical operation. On the prognosis improvement of patients with ureteral carcinoma, postoperative evaluation and treatment should refer to clinical stage, histologic type of lesion and pathology type of lesion.