状分化是否预示着尿膀癌的更糟糕结果?
David Y Yang1, M Francesca Monn1, Hristos Z Kaimakliotis1
1Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana.
Urology practice
|August 10, 2023
概括
膀癌中的状分化不会使预后恶化. 这项研究发现,与非变异性尿道膀癌相比,状分化患者的疾病特异性或全因死亡风险没有增加.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 对变异性组织学对膀癌预后的影响越来越感兴趣.
- 状分化是一种公认的变体,较少常见的变体引起了人们的注意.
- 需要评估状分化与非变异性尿道膀癌在当代急性囊切除术患者中的预后.
研究的目的:
- 评估尿膀癌中状分化是否会比非变异性组织学更糟糕的预后.
- 为了比较患有状分化和没有状分化的患者之间的疾病特异性和整体生存率.
- 分析与膀癌中状分化相关的死亡风险.
主要方法:
- 在10年的时间里,鉴定了患有状分化或非变异性组织学的通过尿道切除和/或囊切除病理的患者.
- 利用Kaplan-Meier方法来评估疾病特异性和整体存活率.
- 采用考克斯回归分析来确定与死亡率相关的变量.
主要成果:
- 在2003年至2013年期间,有934名患者接受了囊切除术;发现了617例非变异和118例状分化病例.
- 状分化病例显示肌肉侵入性疾病的发病率较高 (75%vs. 59%) 和囊切除时非器官受限性疾病的发病率较高 (57%vs. 44%).
- 调整后的分析显示,状分化与疾病特异性 (HR 1.35) 或全因死亡率 (HR 0.90) 的增加无关.
结论:
- 泌尿道膀癌中的状分化与更差的预后无关.
- 与纯无变异性尿道膀癌相比,在疾病特异性或全因死亡率上没有发现显著差异.
- 当代数据支持状分化不能独立预测膀癌患者治疗激进囊切除术的较差结果.
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