上尿路尿路上皮癌根治术后患者膀胱转移的影响因素分析

Influencing factors of bladder metastasis in patients with upper urinary tract urothelial carcinoma after radical surgery

目的探讨上尿路尿路上皮癌根治术后患者膀胱转移的影响因素。方法收集80例上尿路尿路上皮癌患者的临床资料,所有患者均接受上尿路肿瘤根治术,术后进行随访,记录膀胱转移情况。采用Logistic回归模型分析上尿路尿路上皮癌根治术后患者膀胱转移的影响因素。结果术后膀胱转移23例(28.75%),未转移57例(71.25%)。不同性别、年龄、肿瘤部位、肿瘤数目、术前输尿管镜检情况、手术方式上尿路尿路上皮癌根治术后患者的膀胱转移情况比较,差异均无统计学意义(P﹥0.05);吸烟、输尿管肿瘤、T_(3~4)期、G3级、有淋巴结转移上尿路尿路上皮癌根治术后患者的膀胱转移率分别高于不吸烟、肾盂肿瘤、T_(1~2)期、G_(1~2)级、无淋巴结转移患者,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,吸烟、肿瘤位于输尿管、肿瘤分期为T_(3~4)期、肿瘤分级为G3级、有淋巴结转移均是上尿路尿路上皮癌根治术后患者膀胱转移的独立危险因素(P<0.05)。结论吸烟、肿瘤位置、肿瘤分期、肿瘤分级、淋巴结转移情况均是上尿路尿路上皮癌根治术后患者膀胱转移的独立影响因素。

Objective To investigate the influencing factors of bladder metastasis in patients with upper urinary tract urothelial carcinoma after radical surgery.Method The clinical data of 80 patients with upper urinary tract urothelial carcinoma were collected.All patients were treated with radical surgery and followed up after surgery to record the bladder metastasis.The influencing factors of bladder metastasis in patients with upper urinary tract urothelial carcinoma after radical surgery were analyzed by Logistic regression model.Result After surgery,there were 23 cases(28.75%)with bladder metastasis and 57 cases(71.25%)without bladder metastasis.There were no significant differences in the bladder metastasis of upper urinary tract urothelial carcinoma patients with different gender,age,tumor location,tumor number,preoperative ureteroscopy,and surgical methods(P>0.05).The bladder metastasis rate of smoker patients and patients with ureteral tumor,stage T_(3-4),grade G3,lymph node metastasis were higher than non-smoker patients and patients with renal pelvis tumor,stage T_(1-2),grade G_(1-2),and without lymph node metastasis(P<0.05).Multiple Logistic regression analysis showed that smoking,ureteral tumor,stage T_(3-4),grade G3 and lymph node metastasis were risk factors of bladder metastasis in patients with upper urinary tract urothelial carcinoma after radical surgery(P<0.05).Conclusion Smoking,tumor location,tumor stage and grade,and lymph node metastasis are independent influencing factors of bladder metastasis in patients with upper urinary tract urothelial carcinoma after radical surgery.