原发性输尿管癌预后的临床病理因素回顾性分析

为了探讨输尿管癌临床病理因素对预后的影响,回顾性分析1995-01-2008-12接受手术治疗的原发输尿管癌51例患者的临床资料.在51例输尿管癌患者中,年龄(P=0.000)、临床分期(P=0.004)、组织学分级(P=0.000)及手术方式(P=0.048)与输尿管癌手术预后显著相关；性别(P=0.655)、肿瘤部位(P=0.245)及病理分级(P=0.092)与输尿管癌手术预后无关.临床分期中,浅表性输尿管癌(Ta～T1) 10例(19.6％),浸润性输尿管癌(T2～T4)41例(80.4％),Kaplan-Meier法分析显示,浸润性输尿管癌生存率明显低于表浅输尿管癌,P=0.002.多因素Cox回归模型生存分析结果表明,临床分期(P=0.021),组织学分级(P=0.001)、病理分级(P=0.048)及手术方式(P=0.039)是影响手术预后最显著的独立因素.初步研究结果提示,输尿管癌临床病理分级及手术方式与患者的生存相关,可作为患者的独立预后因素.

Retrospective analysis of the clinical parameters and the prognostic factors with ureter transitional cell carcinoma patients

The objective of this study was to study the clinical parameters and prognostic factors in ureter transitional cell carcinoma(TCC) and their correlation with prognosis of patients.Between January 1995 and December 2008 51 TCC patients were treated,and the data was retrospectively analyzed.Univariate analysis identified that were associated with a significant outcome:age(P=0.000),clinical stage(P=0.004),histologic type of lesion(P=0.000) and the way of surgical operation(P=0.048).The sex(P=0.655),location of primary lesion(P=0.245) and pathology type of lesion(P=0.092) were not significantly associated with prognosis.The non-invasive TCC of the clinical stage was found in 10 patients(19.6%) and the invasive TCC in 41 patients(80.4%).Kaplan-Meier was applied to compare that the survival rate of invasive TCC was significantly longer than that of the non-invasive TCC(P=0.002).However,when the interactive effects of these factors were taken into account,the clinical stage(P=0.021),histologic type of lesion(P=0.001),pathology type of lesion(P=0.048) and way of surgical operation(P=0.039) were selected as the most significant prognostic factors in a multivariate analysis by using the Cox proportional hazard regression model.In conclusion,clinical stage,pathological grade and pattern of resection,are related with survival,and they are also independent prognosis factors of TCC.