单中心3065例膀胱癌诊疗分析

Diagnosis and treatment of 3065 cases of bladder cancer in a single center

目的分析郑州大学第一附属医院近年来膀胱肿瘤患者的临床病理特点。方法收集2005年1月至2022年12月于郑州大学第一附院泌尿外科病理诊断为膀胱癌的手术患者资料,分析其一般资料、临床表现和病理特点。结果3065例膀胱癌患者男性患者2279例(74.46%),女性患者786例(25.64%),男女比例为2.9∶1,平均年龄为(62.8±9.4)岁,首发症状为无痛性肉眼血尿者2117例(69.07%),膀胱刺激征164例(5.35%),血尿合并膀胱刺激征395例(12.89%),病理类型方面,尿路上皮癌患者2871例(93.67%),鳞癌患者122例(3.98%),腺癌41例(1.34%),其他病理类型31例(1.01%);临床分期Tis期患者68例(2.21%),Ta期患者747例(24.37%),T1期患者1280例(41.76%),T2期患者905例(29.53%),T3期患者58例(1.89%),T4期7例(0.23%)。经尿道膀胱肿瘤切除术(transurethral resection of bladder tumor,TURBT)手术患者2175例(70.96%),二次电切患者无复发生存时间为22个月,5年无进展生存率86%。膀胱根治性手术患者759例,总并发症发生率为21.48%,患者5年生存率分别为Ta-T1期93%、T2期72%、T3期51%、T4期7%。膀胱根治患者的5年总生存率为71%。结论膀胱癌具有预后差,易复发的特点,关键在于早期诊断和规范的治疗,并积极防治手术相关并发症。

Objective To analyze the clinicopathological features of bladder tumors in the First Affiliated Hospital of Zhengzhou University in recent years.Methods The data of patients with bladder cancer who were pathologically diagnosed in the Department of Urology in the First Affiliated Hospital of Zhengzhou University from January 2005 to December 2022 were collected,and their general data,clinical manifestations and pathological characteristics were analyzed.Results Among the 3065 patients with bladder cancer,2279(74.46%)were males and 786(25.64%)were females,with a ratio of 2.9∶1.and the mean age was(62.8±9.4)years old.The first symptom of bladder cancer was painless gross hematuria in 2117(69.07%)patients,and bladder irritation in 164(5.35%)patients.There were 395 cases of hematuria combined with bladder irritation(12.89%),2871 cases were urothelial carcinoma(93.67%),122 cases were squamous cell carcinoma(3.98%),41 cases were adenocarcinoma(1.34%),and 31 cases were other pathological types(1.01%).There were 68 patients with Tis stage(2.21%),747 patients with Ta stage(24.37%),1280 patients with T1 stage(41.76%),905 patients with T2 stage(29.53%),58 patients with T3 stage(1.89%),and 7 patients with T4 stage(0.23%).In 2175 patients with transurethral resection of bladder tumor(TURBT)surgery(70.96%),the relapse-free survival time was 22 months and the 5-year progression-free survival rate was 86%.The total complication rate was 21.48%in 759 patients underwent radical bladder surgery.The 5-year survival rates were 93%in Ta-T1,72%in T2,51%in T3,and 7%in T4.The 5-year overall survival rate was 71%.Conclusion Bladder cancer has the characteristics of poor prognosis and easy recurrence,the key lies in early diagnosis and standard treatment.The prevention and treatment of complications related to the operation is very important.