肿瘤淋巴管入侵与无淋巴结转移膀胱癌复发及预后的相关性分析

Correlative Analysis of Tumor Lymphatic Invasion with the Recurrence and Prognosis of Bladder Cancer with Negative Lymph Nodes Metastasis

目的:分析肿瘤淋巴管入侵与无淋巴结转移膀胱癌复发和预后之间的关系。方法:选取临床资料完整的膀胱癌病例72例,分为淋巴结转移组(32例)和无淋巴结转移组(40例)。采用Spearman相关分析探讨淋巴管入侵与膀胱癌复发和预后的相关性,应用Kaplan-Meier法描绘生存曲线,Cox比例危险度模型筛选影响膀胱癌患者预后的因素。结果:在72例膀胱癌组织中,淋巴管入侵的阳性率是48.6%(35/72),淋巴管入侵的阳性率随肿瘤分期和分级增加而显著升高(P<0.05);淋巴结转移组的淋巴管入侵阳性率为68.8%(22/32),显著高于无淋巴结转移的32.5%(13/40)。淋巴管入侵与膀胱癌的临床分期、分级、淋巴结转移以及无淋巴结转移膀胱癌复发均显著相关(P<0.05)。淋巴管入侵阴性的患者的五年总体生存率显著高于淋巴管入侵阳性者,淋巴管入侵是无淋巴结转移膀胱癌复发和预后不良的危险因素。结论:肿瘤淋巴管入侵与膀胱癌临床分期和淋巴结转移密切相关,并影响膀胱癌患者的总体生存率,可作为无淋巴结转移膀胱癌复发和预后的预测因素。

Objective： To investigate the correlations of lymphatic vessel invasion with recurrence and prognosis of bladder cancer with negative lymph node metastasis. Methods： Seventy-two paraffin embedded stored specimens from patients of bladder cancer with pathological diagnosis were included in this study and divided into lymph node metastatic group （n=32） and non-metastatic group （n=40）. Spearman correlation analysis was used for statistical correlation analysis between lymphatic vessel invasion and recurrence as well as prognosis of bladder cancer. The overall survival curve was formed by Kaplan-Meier analysis. Analysis of prognostic factors was based on the Cox proportional hazards model. Results： There were 35 cases showed positive lymphatic vessel invasion, prevalence of lymphatic vessel invasion increased with higher clinical stage and grade. The positive rate was 68.8 %（22/32） in lymph node group and 32.5 % （13/40） in non-metastasis group respectively. The tumor lymphatic vessel invasion was related with the clinical stage, grade, lymph node metastasis status and lymph node negative metastasis recurrence as well as prognosis of bladder cancer（P〈0.05）. The overall survival with negative lymphatic vessel invasion was significantly higher than that with positive lymphatic vessel invasion by Kaplan- Meier analysis. Tumor lymphatic vessel invasion was the indicator for the recurrence and prognosis of bladder cancer negative lymph node metastasis by multivariate Cox regression analysis. Conclusion： Tumor lymphatic vessel invasion was correlated with the clinical stage and lymph node metastasis in bladder cancer, and affected the overall survival of patients with bladder cancer, which could be con- sidered as the predictive factor of recurrence and prognosis of bladder cancer.