代谢综合征对非肌层浸润性膀胱肿瘤二次电切阳性的临床意义

Clinical significance of metabolic syndrome in re-TURBT of non-muscular invasive bladder cencer

目的探讨代谢综合征(MS)对非肌层浸润性膀胱肿瘤二次电切阳性的影响因素及对术后复发的影响。方法回顾性收集北京医院泌尿外科2013年1月至2018年12月因非肌层浸润性膀胱肿瘤行二次经尿道膀胱肿瘤电切术(re-TURBT)患者的临床资料以及术后定期随访资料,共计92例,分为MS组(n=50)和非MS组(n=42),分析2组患者的re-TURBT阳性的影响因素及对术后复发的影响情况。结果MS组re-TURBT的阳性率(34.0%),术后3个月阳性患者复发率为29.4%,阴性患者无复发,总复发率为10.0%;非MS的re-TURBT的阳性率(19.0%),术后3个月阳性患者和阴性患者无复发,总复发率为0%。MS组和非MS组re-TURBT的阳性率无统计学意义,二者的阳性患者复发率和总体复发率有统计学意义(P<0.05)。Logistics回归分析体质指数(BMI)、血糖、血脂及肿瘤大小是re-TURBT阳性率的独立因素。结论非肌层浸润性膀胱癌合并MS的患者re-TURBT的阳性率不高于非MS患者,但是与re-TURBT的结果和复发相关。

Objective To investigate the effect of metabolic syndrome(MS)on the positive rate and recurrence of repeat transurethral resection of bladder tumor(re-TURBT)of non-muscular invasive bladder cancer(NMIBC).Methods Clinical and follow-up data of 92 NMIBC cases who received re-TURBT during Jan.2013 and Dec.2018 were retrospectively analyzed.The patients were divided into MS group(n=50)and non-MS group(n=42).The influencing factors of re-TURBT and recurrence were compared between the two groups.Results In the MS group,the positive rate of re-TURBT was 34.0%,3-month recurrence rate was 29.4%in the positive patients and 0 in the negative patients,and the total recurrence rate was 10.0%.In the non-MS group,the positive rate of re-TURBT was 19.0%,3-month recurrence rate was 0 in both positive and negative patients,and the total recurrence rate was 0.There was no significant difference in the positive rate of re-TURBT between MS group and non-MS group,but there was statistical significance in the recurrence rate of positive patients and overall recurrence rate(P<0.05).Logistic regression analysis showed that BMI,blood glucose,blood lipid and tumor size were independent factors of the positive rate of re-TURBT.Conclusion The positive rate of re-TURBT in NMIBC patients complicated with MS is not higher than that in NMIBC patients without MS,but MS is related to the results of re-TURBT and recurrence.