糖尿病对非肌层浸润性膀胱癌患者复发和进展的影响

Effect of diabetes mellitus on recurrence and progression of patients with non-muscle invasive bladder cancer

目的探讨非肌层浸润性膀胱癌(NMIBC)患者中糖尿病(DM)与肿瘤复发和进展的关系。方法回顾性分析2015年1月至2016年10月河南科技大学第一附属医院收治的159例经尿道膀胱肿瘤电切术(TURBT)治疗的NMIBC患者资料。根据患者手术时是否患有糖尿病分为糖尿病组(50例)和非糖尿病组(109例)。采用Kaplan-Meier法制作生存曲线,采用C0X回归模型分析糖尿病与NMIBC的无复发生存期(KFS)和无进展生存期(RFS)的相关性。结果与非糖尿病组相比较,糖尿病组患者的肿瘤分期、高血压、复发率更高,而肿瘤分级更低(P<0.05)。单因素生存分析显示,T1、糖尿病、化疗、吸烟、肿瘤单发与NMIBC患者的RFS相关(P<0.05),而性别、饮酒史、肿瘤分级对NMIBC患者的PFS无相关性(P>0.05):性别、抽烟史、饮酒史、肿瘤分级、肿瘤分期、肿瘤单发,化疗、高血压、糖尿病对NMINC患者的PFS无明显影响。多因素C0X生存分析显示吸烟、性别(男性)和糖尿病与增加复发风险相关(P<0.05),而化疗可以降低复发风险,而高级别与PFS增加相关(P<0.05)。结论糖尿病是NMI-BC患者RFS的独立预测因子。

Objective To investigate the relationship between diabetes mellitus(DM)and tumor recurrence and progression in patients with non muscle invasive bladder cancer(NMIBC).Methods A retrospective analysis of 159 cases of NMIBC treated by transurethral bladder turner resection(TLRBT)in the first affiliated hospital of henan university of science and technology from January 2015 to October 2016 was conducted.According to whether patients had DM during operation,they were divided into two groups,DM group(50 cases)and non-DM group(109 cases).Kaplan-Meier methods were used to make sunival curves.COX regression models were used to analyse the association between DM and recurrence-free survival(RFS)and progression-free survival(PFS)of NMIBC.Results Compared with the non-DM group,the staging,hypertension and recurrence rate in the DM group were higher.Grading was lower(P<0.05).Univariate survival analysis showed that T1,diabetes mellitus,chemotherapy,smoking and single incidence of tumor were correlated with RFS in NMIBC patients(P<0.05),while gender,drinking history and tumor grade had no correlation with RFS in NMIBC patients(P>0.05).Gender,smoking history,drinking history,tumor grade,tumor stage,single tumor,chemotherapy,hypertension and diabetes mellitus had no significant effect on PFS in NMINC patients.Multivariate COX survival analysis showed that smoking,sex(male),and diabetes were associated with an increased risk of recurrence(P<0.05),while chemotherapy was associated with a reduced risk of recurrence,and high grade was associated with an increased risk of PFS(P<0.05).Conclusions DM is an independent predictor of RFS in NMIBC patients.