摘要
目的 探讨肌层浸润性膀胱癌患者根治性膀胱切除术的预后影响因素.方法 选择北京协和医院2008年1月至201 1年6月所收治的肌层浸润性尿路上皮细胞癌患者36例,采用Kaplan-Meier法以及Cox比例回归风险模型对预后影响因素包括患者的性别、年龄、TNM临床分期、术前是否行新辅助化疗、肿瘤数目、肿瘤大小、术后3个月卡氏评分、碱性磷酸酶、乳酸脱氢酶、血红蛋白等因素进行分析.结果 36例患者1年生存率为86.1％ （31/36）,3年生存率为75.0％ （27/36）.单因素分析发现,术前行新辅助化疗和术后卡氏评分是对根治性膀胱切除术预后有影响的因素（x2=8.532,P=0.003;x2=5.482,P=0.003）.Cox比例回归风险模型分析提示术前行新辅助化疗是影响预后的独立因素（P=0.037,相对危险度0.107,95％置信区间：0.013 ～0.873）.结论 根治性膀胱切除术的预后与患者术前行新辅助化疗有关,样前行新辅助化疗为保护因子.
Objective To explore the prognosis factors of radical cystectomy in patients with muscleinvasive bladder cancer factors of radical bladder cystectomy.Methods Clinical data of 36 cases with muscleinvasive bladder cancer after radical cystectomy from January 2008 to June 2011 were selected.Kapplan-Meier method and Cox regression model were used to analyze the prognosis factors including sex,age,hematuria,clinical staging,neoadjavant chemotherapy,tumor number,tumor size,Kamofsky scores 3 months after operation,alkaline phosphatase,lactic dehydrogenase and hemoglobin..Results The 1 year and 3 years survival rates were 86.1% （31/36） and 75% （27/36）,respectively.Kaplan-Meier method showed that preoperative neoadjavant chemotherapy and postoperative Karnofsky scores were the influencing factors of prognosis （x2 =8.532,P =0.003 ; x2 =5.482,P =0.003）.Cox regression model showed that preoperative neoadjuvant chemotherapy was the independent factor of prognosis （P =0.037,RR =0.107,95% CI：0.013-0.873）.Conclusion There is a correlation between prognosis of radical cystectomy and preoperative neoadjuvant chemotherapy in patients with muscle-invasive bladder cancer; preoperative neoajuvant chemotherapy is the protective factor.
出处
《中国医药》
2015年第9期1344-1346,共3页
China Medicine
