低恶性潜能尿路上皮乳头状肿瘤的复发和进展因素

Q4 Medicine

中华泌尿外科杂志 Pub Date : 2020-01-15 DOI:10.3760/CMA.J.ISSN.1000-6702.2020.01.002

Wanxiang Zheng, Xuelin Gao, G. Hou, Longlong Zhang, Di Wei, Luguang Huang, C. Tian, Geng Zhang, Jianlin Yuan

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All patients received transurethral resection of bladder tumor (TURBT) and 136 patients received bladder infusion chemotherapy, including 61 patients for pirarubicin, 58 patients for gemcitabine, 11 patients for epirubicin, and 11 patients for mitomycin. 14 patients did not receive bladder infusion chemotherapy. In this study, univariate and multivariate logistic regression analysis were used to investigate independent predictors of recurrence and pathological progression in patients of bladder PUNLMP who received TURBT. \n \n \nResults \nThe average follow-up time was 25.6 months, ranging 5.5-122.7 months. Among the patients, 21 patients occurred recurrence. The recurrent duration ranged from 2.2 to 108.3 months (mean 23.1 months). 12 patients had pathological progression, including 9 patients for low-grade non-invasive papillary urothelial carcinoma, 1 patient for high-grade non-invasive papillary urothelial carcinoma, 1 patient for high-grade invasive urothelial carcinoma, 1 patient for squamous cell carcinoma. The progressive duration ranged from 2.2 to 56.3 months (mean 21.5 months). Among the 150 patients, 18 patients with inverted growth pattern did not recur. There were significant differences in the number of tumors and the tumor length between the recurrence and non-recurrence groups, same as the progression and non-progression groups. The univariate and multivariate logistic regression analysis results showed that the number of tumors was an independent predictor of tumor recurrence (OR=7.884, 95%CI 2.815-22.082, P<0.05)and progression(OR=6.107, 95%CI 1.659-22.473, P=0.006) in patients of bladder PUNLMP. 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引用次数: 0

摘要

目的探讨膀胱低恶性潜势乳头状尿路上皮肿瘤(PUNLMP)的病理特点及复发和病理进展的预测因素。方法回顾性分析2009年2月至2019年2月西京医院泌尿外科收治的150例膀胱PUNLMP患者。150例患者中，男性118例，女性32例。平均年龄57岁，20 ~ 93岁不等。单发肿瘤112例，多发肿瘤38例。所有患者均行经尿道膀胱肿瘤切除术(TURBT)， 136例患者行膀胱输注化疗，其中吡柔比星61例，吉西他滨58例，表柔比星11例，丝裂霉素11例。14例患者未接受膀胱输注化疗。本研究采用单因素和多因素logistic回归分析，探讨膀胱PUNLMP患者接受TURBT治疗后复发和病理进展的独立预测因素。结果随访5.5 ~ 122.7个月，平均25.6个月。其中21例出现复发。复发时间2.2 ~ 108.3个月，平均23.1个月。12例患者病理进展，其中低级别无创乳头状尿路上皮癌9例，高级别无创乳头状尿路上皮癌1例，高级别浸润性尿路上皮癌1例，鳞状细胞癌1例。病程进展为2.2 ~ 56.3个月(平均21.5个月)。在150例患者中，18例生长模式倒置的患者未复发。复发组和非复发组在肿瘤数量和肿瘤长度上有显著差异，进展组和非进展组也有显著差异。单因素和多因素logistic回归分析结果显示，肿瘤数量是膀胱PUNLMP患者肿瘤复发(OR=7.884, 95%CI 2.815 ~ 22.082, P<0.05)和进展(OR=6.107, 95%CI 1.659 ~ 22.473, P=0.006)的独立预测因子。膀胱输注化疗未能降低复发和进展的风险。结论约14%(21/150)的膀胱PUNLMP患者在TURBT术后复发。约半数患者有病理进展，多数发展为低级别非侵袭性乳头状尿路上皮癌。多发性肿瘤是术后复发和进展的独立危险因素。膀胱输注化疗不能降低膀胱PUNLMP患者复发和进展的风险。关键词:膀胱肿瘤;低恶性潜能乳头状尿路上皮肿瘤(PUNLMP);复发;进展

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Recurrence and progression factors of papillary urothelial neoplasm of low malignant potential

Objective To investigate the pathological characteristics of bladder low malignant potential papillary urothelial tumors (PUNLMP) and the predic factors of recurrence and pathological progress. Methods We retrospectively analyzed 150 patients of bladder PUNLMP in the Department of Urology of Xijing Hospital from February 2009 to February 2019. Among the 150 patients, 118 patients were males and 32 patients were females. The average age was 57 years, ranging 20-93 years. There were 112 cases of single tumor and 38 cases of multiple tumor. All patients received transurethral resection of bladder tumor (TURBT) and 136 patients received bladder infusion chemotherapy, including 61 patients for pirarubicin, 58 patients for gemcitabine, 11 patients for epirubicin, and 11 patients for mitomycin. 14 patients did not receive bladder infusion chemotherapy. In this study, univariate and multivariate logistic regression analysis were used to investigate independent predictors of recurrence and pathological progression in patients of bladder PUNLMP who received TURBT. Results The average follow-up time was 25.6 months, ranging 5.5-122.7 months. Among the patients, 21 patients occurred recurrence. The recurrent duration ranged from 2.2 to 108.3 months (mean 23.1 months). 12 patients had pathological progression, including 9 patients for low-grade non-invasive papillary urothelial carcinoma, 1 patient for high-grade non-invasive papillary urothelial carcinoma, 1 patient for high-grade invasive urothelial carcinoma, 1 patient for squamous cell carcinoma. The progressive duration ranged from 2.2 to 56.3 months (mean 21.5 months). Among the 150 patients, 18 patients with inverted growth pattern did not recur. There were significant differences in the number of tumors and the tumor length between the recurrence and non-recurrence groups, same as the progression and non-progression groups. The univariate and multivariate logistic regression analysis results showed that the number of tumors was an independent predictor of tumor recurrence (OR=7.884, 95%CI 2.815-22.082, P<0.05)and progression(OR=6.107, 95%CI 1.659-22.473, P=0.006) in patients of bladder PUNLMP. Bladder infusion chemotherapy failed to reduce the risk of recurrence and progression. Conclusions About 14% (21/150) patients of bladder PUNLMP reoccurred after TURBT. About half of them had pathological progression, and most of them progressed to low-grade non-invasive papillary urothelial carcinoma. Multiple tumors was an independent risk factor for postoperative recurrence and progression. Bladder infusion chemotherapy did not reduce the risk of recurrence and progression in patients of bladder PUNLMP. Key words: Urinary bladder neoplasms; Papillary urothelial neoplasms of low malignant potential(PUNLMP); Recurrence; Progression

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来源期刊

中华泌尿外科杂志 Medicine-Nephrology

CiteScore

0.10

自引率

0.00%

发文量

14180

期刊介绍： Chinese Journal of Urology (monthly) was founded in 1980. It is a publicly issued academic journal supervised by the China Association for Science and Technology and sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. This journal mainly reports on the latest scientific research results and clinical diagnosis and treatment experience in the professional field of urology at home and abroad, as well as basic theoretical research results closely related to clinical practice. The journal has columns such as treatises, abstracts of treatises, experimental studies, case reports, experience exchanges, reviews, reviews, lectures, etc. Chinese Journal of Urology has been included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences), CSCD Chinese Science Citation Database Source Journal (including extended version), and also included in American Chemical Abstracts (CA). The journal has been rated as a quality journal by the Association for Science and Technology and as an excellent journal by the Chinese Medical Association.