预后肌层浸润性膀胱癌患者新辅助化疗病理反应的临床因素分析

Analysis of the clinical factors in the prognosis of pathologic response after neoadjuvant chemotherapyfor patients with invasive bladder cancer

目的本研究主要探究预后新辅助化疗病理反应的临床因素。方法收集2009年2月至2014年10月肌层浸润性膀胱癌患者75例，分为pT0组（21例，患者有完整的病理反应）和非-pT0组（54例，患者仍有残留疾病或进展性疾病），收集患者的基本临床病理数据，行比较分析和Logstie回归分析，以评估预后效果。结果仅28％（21／75）的患者接受NAC后有完整的病理反应（pT0），pT0组患者中仅患尿路上皮癌的比率（66．67％，14／21）显著高于非-pT0的患者48．15％（26／54）（χ2=3．296，P=0．002），Logstie回归分析发现肌层浸润性膀胱癌患者的仅患尿路上皮癌特征（与混合癌相比较）是pT0的良好预测因子（P〈0．05）。结论仅患尿路膀胱癌的患者其pT0的几率显著高于}昆合癌患者，仅患尿路上皮癌的特征是pTO的良性预测因素。

Objective To explore the clinical factors in the prognosis of pathological response after neoadjuvant chemotherapy. Methods Clinical data of 75 patients with muscle invasive bladder cancer between February 2009 and October 2014 who were divided into pT0 group （21 cases with com- plete pathologic response ） and non -pT0 group （ 54 cases with esidual or progressive disease） were collected, and basic clinical pathological characteristics were analyzed and compared by logstic regres- sion analysis to assess prediction effects. Results In the study, 21 patients attained complete patho- logic response （pT0） after NAC, the ratio of patients with only urothelial carcinoma in pT0 group [ 66. 67% （14/21） ] was significantly higher than non -pT0 patients [48.15% （26/54） ] （χ2 = 3. 296,P = 0. 002 ）, and logstic regression analysis showed that invasive bladder cancer patient with only urothelial carcinoma （ compared mixture carcinoma ） was a good predictor for pT0 （ P 〈 0.05 ）. Con- clusions The pT0 of patients with pure urothelial carcinoma has a higher ratio than patients with mix- ture carcinoma , so only urothelial carcinoma is a good predictor for pT0.