代谢综合征与其组分对T_1期高级别膀胱癌患者生存状况的影响

Effects of MS and its components on the survival of T1 high-grade bladder cancer

目的探讨代谢综合征(MS)与其分组对T1期高级别膀胱癌患者生存状况的影响。方法选取2010年6月至2015年12月期间于我院首次确诊并行经尿道膀胱肿瘤切除术的169例原发性T1期高级别膀胱癌患者为研究对象,并分为MS组(n=19)与非MS组(n=150),肥胖组(n=83)与非肥胖组(n=86),高血压组(n=60)与非高血压组(n=109),糖尿病(DM)组(n=35)与非DM组(n=134),高血脂组(n=29)与非高血脂组(n=140)。比较各组的复发率、进展率、无复发生存期(RFS)与无疾病进展生存期(PFS),采用单因素Cox比例风险模型对MS及各个组分与预后的关系进行分析。结果全部患者均进行了术后随访7~69个月,中位随访时间为33.2个月,有105例(62.1%)出现肿瘤复发,72例(42.6%)出现肿瘤进展,平均RFS与PFS分别为27.18个月和38.06个月。MS组的进展率显著高于非MS组,肥胖组的复发率和进展率均显著高于非肥胖组,DM组的复发率和进展率均显著高于非DM组,差异有统计学意义(P<0.05)。MS组的平均RFS与PFS显著低于非MS组,肥胖组的平均RFS与PFS显著低于非肥胖组,DM组的平均RFS与PFS显著低于非DM组,差异有统计学意义(P<0.05)。单因素Cox比例风险模型结果表明肥胖与DM均可增加患者肿瘤复发和进展的风险(P<0.05),而MS、高血压、高血脂与患者术后复发与进展的风险均无显著相关性(P>0.05)。结论肥胖、糖尿病可增加T1期高级别膀胱癌患者术后复发、进展的风险,而MS、高血压、高血脂与患者的生存状况无显著相关性。

Objective To investigate the effects of metabolic syndrome （MS） and its components on the survival of T1 high-grade bladder cancer. Methods A total of 169 patients with Tl high-grade bladder cancer who underwent transurethral resection of bladder tumor during Jun. 2010 and Dec. 2015 in our hospital were enrolled in the study. The patients were divided into MS group （ n = 19） and non-MS group （ n = 150） ; obesity group （ n = 83） and non-obesity group （ n = 86） ; hypertension group （n=60） and non-hypertension group （n=109）. diabetes mellitus （DM） group （n=35） and non-DM group （n = 134）; hyperlipemia group （ n = 29） and non-hyperlipemia group （ n = 140）. The rates of recurrence, progression, relapse free survival （RFS）, and progression free survival （PFS） were compared among all groups. Univariate Cox regression model analysis was per- formed to analyze the relationship between prognosis and MS and its components. Results All patients were followed up for 7 --69 months,and the median follow-up was 33.2 months. Tumor recurrence and progression occurred in 105 （62.1%） and 72 cases （42.6%）,respectively. The average RFS and PFS were 27.18 and 38.06 months, respectively. The progression rate was significantly higher in MS group than in non-MS group; the recurrence and progression rates were significantly higher in obesity group and DM group than in non-obesity group and non-DM group, respectively, （P〈0.05）. The average RFS and PFS were significantly lower in MS group, obesity group, and DM group than in non-MS group, non-obesity group, and non-DM group, re- spectively （P〈0.05）. Univariate Cox regression model analysis showed that obesity and DM could increase postoperative risk of recurrence and progression （P〈0.05）, while there were no significant correlation between MS, hypertension, hyperlipidemia and risk of recurrence and progression （P〉0.05）. Conclusion Obesity and DM could increase postoperative risk of recur- rence and hyperlipidemia showed no significant correlation with patients＇ survival.