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通过尿道切除和激进囊切除之间的组织学异常的预后影响
Ayumu Matsuda1, Rikiya Taoka2, Jun Miki3,4
1Department of Urology, National Cancer Center Hospital, Tokyo, Japan.
BJU international
|February 12, 2024
概括
激进囊切除 (RC) 样本中的组织学亚型,而不是通过尿道切除 (TUR) 样本,影响膀癌的预后. 对于在TUR样本中具有亚型/分离差异化 (DD) 的患者,中性粒细胞-淋巴细胞比率和病态阶段预测整体存活率.
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:
- 膀癌的治疗通常涉及通过尿道切除 (TUR),然后进行激进囊切除术 (RC).
- TUR和RC标本之间的组织学不一致,包括亚型或分离差异化 (DD),可能会影响患者的结果.
- 了解这种不一致对于准确的预后和治疗计划至关重要.
研究的目的:
- 分析 TUR 和 RC 标本之间的组织学异常 (亚型或 DD) 对接受RC的膀癌患者的结局的影响.
- 为了确定患有亚型/DD膀癌的患者整体生存期 (OS) 的预测因素.
主要方法:
- 对2570名膀癌患者接受RC治疗 (2013-2019) 的日本全国队列的分析.
- 非尿路无复发存活率 (NUTR-FS) 和基于TUR或RC样本组织学的OS的分层.
- 多变量考克斯回归分析,以确定患有亚型/DD的患者OS的预后因素.
主要成果:
- 根据TUR样本分类 (纯甲状腺癌,亚型,DD,非UC),没有观察到OS或NUTR-FS的显著差异.
- 在RC标本中的组织学亚型显著影响了预后.
- 在TUR标本中具有亚型/DD的患者中,RC前的中性粒细胞-淋巴细胞比率和病态阶段是OS的独立预后因素.
结论:
- 在RC标本中存在亚型/DD,但在TUR标本中没有,表明膀癌患者的预后不佳.
- 中性粒细胞-淋巴细胞比率和病态阶段是TUR标本中亚型/DD患者的OS的关键独立预后因素.
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