肿瘤危险因素评分对非肌层浸润性膀胱肿瘤预后判断的价值（附248例报告）

目的：评价膀胱肿瘤复发及进展评分对非肌层浸润性膀胱肿瘤预后判断的价值。方法：收集自2006年7月～2010年3月于我院接受腔内治疗的248例T0和T1期膀胱肿瘤患者临床资料，记录肿瘤数量、肿瘤大小、肿瘤临床分期、病理级别、既往有无肿瘤复发及有无伴随原位癌等相关资料，以EORTC（The European Organization for Research and Treatment of Cancer）肿瘤风险评分表对患者评分，随访术后患者肿瘤复发及进展情况。结果：本组肿瘤复发危险评分为O～15分，平均（4．37±2．93）分；肿瘤进展危险得分为0～23分。平均（5．21±3．95）分。随访3～60个月，平均（25．8±18．5）个月，共有123例（49．6％）肿瘤复发，平均（11．4±6．5）个月。87例（70．7％）于1年内肿瘤复发，36例（29．3％）复发超过1年。24例（19．5％）肿瘤进展[平均（9．8±6．2）个月]。复发评分0～2分者肿瘤复发不足20％，进展评分0～2分者肿瘤无进展。3分者肿瘤进展率为6．1％。肿瘤数量是肿瘤复发与进展的首要危险因素，相对危险度分别为2．229和5．246。结论：肿瘤复发及进展评分可简便准确地判断非肌层浸润性膀胱肿瘤患者预后，但仍有修改与完善的必要。

The Efficacy of the EORTC Risk Table for the Prediction of Recurrence and Progression of Non-Muscle-Invasive Bladder Cancer:Report of 248 Cases

Objective:To value the efficacy of the EROTC Risk Scoring System and Risk Tables for the prediction of recurrence and progression of non-muscle-invasive bladder cancer.Methods:248 patients who were diagnosed as T₀ or T₁ bladder cancer from 2006.7 to 2010.3 were analyzed.The basic tumor dala,including the tumor quantity,size,grade,T category,prior recurrence history and accompanied with CIS or not were recorded. We scored these patients followed the EROTC Risk Scoring System and Risk Tables,and surveyed their recurrence and progression rate after transurethral tumor resection.Results:The score of tumor recurrence was 0-15, mean（4.37±2.93）,and the score of tumor regression was 0-23,mean（5.21±3.95）.During 3-60 months （mean 25.8±18.5 months） follow-up period,123（49.6%）lumor recurrences were detected（mean 11.4±6.5 months）,and the tumors in 87 cases（70.7%）recurred within 12 months post operative.24（19.5%）tumor progression were detected（mean 9.8±6.2 months）.The recurrence rale was less than 20%in the patients with 0-2 recurrence score,and no progression case was delected in the patients with progression score less than 2.6.1% progression rate was for the patients scored 3 in progression score.The tumor quantity was the first risk factor for both of tumor recurrence and progression,the hazard rale was 2.229 and 5.246 respectively.Conclusions:The EORTC scoring table is effective for the prognosis of non-muscle-invasive bladder cancer.It is still necessary to modify for adapting the needs of Chinese patients cohorts.