摘要
目的：探讨非肌层浸润性膀胱癌（non-muscle-invasive bladder cancer,NMIBC）合并糖尿病患者的预后及意义。方法：回顾性分析我院2012年1月-2013年12月经病理检查回报为NMIBC的200例患者临床资料,将患者分为糖尿病组（41例）和非糖尿病组（159例）。所有患者均为首发尿路上皮癌。运用Kaplan-Meier法单因素分析各临床病理特点对患者无复发生存期（recurrence-free survival,RFS）和无进展生存期（progressionfree survival,PFS）的影响,并用Log-rank检验比较生存曲线,运用Cox回归模型多因素分析糖尿病与NMIBC之间的关系,并评估影响其RFS和PFS的预后因素。结果：200例NMIBC患者平均随访14.2（4-40）个月,糖尿病组和非糖尿病组肿瘤复发率分别为34.1%（14/41）和28.3%（45/159）,中位无复发生存时间分别为12.0个月（4-38个月）和14.7个月（5-40个月）,肿瘤进展率分别为9.8%（4/41）和6.9%（11/159）,糖尿病组较非糖尿病组肿瘤复发率高（χ^2=4.875,P=0.027）,无复发生存时间短（P〈0.001）,而进展率的差异无统计学意义（P=0.770）。Cox多因素生存分析显示糖尿病（P〈0.001,HR=2.731）、肿瘤大小（P=0.012,HR=2.344）和NMIBC更高的复发风险相关,而灌注药物（P〈0.001,HR=0.110）会显著降低NMIBC的复发风险。结论：糖尿病是NMIBC患者RFS的独立危险因素,患有糖尿病的NMBIC患者术后复发率更高。
Objective：To evaluate the prognosis and significance of non-muscle-invasive bladder cancer（NMIBC）in patients with diabetes mellitus（DM）.Method：The data of 200 patients with NMIBC from January 2012 to December 2013 were analyzed retrospectively.We divided them into DM group and non-DM group.Recurrencefree survival（RFS）and progression-free survival（PFS）were calculated according to the Kaplan-Meier model and compared by the log-rank model.Cox regression models were used for multivariate analyses of the association between DM and NMIBC,then the prognostic factors affecting RFS and PFS were evaluated.Result：Of these 200 NMIBC patients,DM group accounted for 20.5%（41/200）,and non-DM group accounted for 79.5%（159/200）.The mean follow-up period was 14.2（range,4-40）months.Patients in DM group and non-DM group recurrence rate were 34.1%（14/41）and 28.3%（45/159）respectively,RFS were 12.0（range,4-38）months and14.7（range,5-40）months respectively,and progression rate were 9.8%（4/41）and 6.9%（11/159）respectively.The recurrence rate of DM group was higher than that of non-DM group（χ^2=4.875,P=0.027）,and RFS was shorter（P〈0.001）.However,there was no statistically significant difference in progression rate.Multivariable Cox regression analysis showed that DM（P〈0.001,HR=2.731）and tumor size（P=0.012,HR=2.344）were associated with higher risk of recurrence.On the other hand,intravesical instillation can significantly reduce the risk of recurrence of NMIBC.Conclusion：DM is an independent predictor of RFS in NMIBC patients,and the postoperative recurrence rate of NMIBC patients with DM is higher.
出处
《临床泌尿外科杂志》
2016年第4期344-348,共5页
Journal of Clinical Urology
基金
国家自然科学基金(编号30700834)
天津市自然科学基金(编号12ZCDZSY16600)
天津市应用基础与前沿技术研究计划(编号14JCYBJC26300)
天津市应用基础与前沿技术研究计划(编号15JCYBJC24600)
天津医科大学科学基金(编号2011ky23)
关键词
非肌层浸润性膀胱癌
糖尿病
预后
non-muscle-invasive bladder cancer
diabetes mellitus
prognosis
作者简介
通信作者：吴长利，Email：wujygc2003@163．com
