初发非肌层浸润性膀胱癌肿瘤位置与预后相关性分析

Correlation between tumor location and prognosis of primary non-muscle-invasive bladder cancer

目的探讨初发非肌层浸润性膀胱癌不同肿瘤位置与预后的相关性。方法选取2013年1月至2020年12月该院收治的402例行经尿道膀胱肿瘤等离子电切术的初发非肌层浸润性膀胱癌患者作为研究对象。收集膀胱肿瘤位置、病理分期等资料,将肿瘤位置分为侧壁、后壁、前壁、三角区、顶部、输尿管口和膀胱颈,以术后进展为研究终点,肿瘤进展包括单发至多发,分期或分级的进展。分析膀胱肿瘤不同位置与预后的关系。随访时间35(18,55)个月。结果402例患者中出现进展60例(14.9%),1、5年总进展率分别为5.8%和13.7%。膀胱各肿瘤位置的T分期存在显著差异,其中三角区肿瘤与更高的分期相关。膀胱颈、三角区、pT1期、高级别是患者术后进展的独立危险因素。结论相对其他部位,三角区肿瘤的分期更高;膀胱颈和三角区肿瘤患者术后进展风险较高,膀胱颈和三角区可能是初发非肌层浸润性膀胱癌的不良预后因素。

Objective To investigate the correlation between different tumor locations and prognosis of primary non-muscular invasive urothelial carcinoma of bladder.Methods A total of 402 patients with primary non-muscular invasive bladder cancer treated by transurethral plasmakinetic resection for bladder tumor in the First Affiliated Hospital of Chongqing Medical University from January 2013 to December 2020 were selected as the study subjects.The data such as the location and pathological stage of bladder tumor were collected.The tumor location was divided into the lateral wall,posterior wall,anterior wall,trigone,dome,ureteral orifice and bladder neck.The postoperative progression served as the study end point.The tumor progression included single to multiple,stage or grade progression.The relationship between the different locations of bladder tumor and prognosis was analyzed.The follow-up time was 35 months.Results Among 402 cases,60 cases(14.9%)developed the progression.The overall progression rates in 1 and 5 years were 6.0%and 13.7%,respectively.There were significant differences in the T stages had significant difference among various bladder tumors sites,in which the trigone tumors were related to the higher stages.The bladder neck,trigone region,pT1 stage and high grade were the independent risk factors for postoperative progression.Conclusion Compared with the other sites,the tumor stage of trigone tumors is higher,the postoperative progression risk for the patients with tumor in bladder neck and trigone is higher.The bladder neck and trigone may be the poor prognostic factors for primary non-muscular invasive bladder cancer.