经尿道电切术治疗的膀胱尿路上皮肿瘤病理特点及与预后相关性研究

目的探讨世界卫生组织(World Health Organization,WTO)2004年采纳的尿路上皮肿瘤病理分类(WHO2004)对于肿瘤预后的价值。方法采用WHO2004分类系统,回顾性总结384例经尿道电切术治疗的膀胱尿路上皮肿瘤的病理特点和随访结果。结果单因素Kaplan-Meier生存分析,Log-rank对数秩检验结果显示,不同分类的肿瘤总体比较,肿瘤复发率、进展率、癌相关病死率差异有统计学意义(P<0.05),非浸润性乳头状癌(Ta)与癌细胞突破尿路上皮基底膜浸润至固有膜内的T1期肿瘤比较,肿瘤进展率和病死率差异有统计学意义(P<0.05)。结论 WHO2004尿路上皮肿瘤分类能够较好反映肿瘤的预后,高级别癌较低级别癌更具有侵袭性,肿瘤分级是肿瘤预后的重要指标。

Association of WHO2004 pathological classification of bladder urothelial tumors with the outcome

Objective To evaluate efficacy of the 2004 World Health Organization (WHO)/International Society of Urological Pathology (ISUP) classification in prediction of recurrence, progression and cancer-specific mortality. Methods The dates of 384 patients who underwent transurethral resection of primary urothelial tumors were retrospectively studied. Results The difference of recurrence, progression and cancer-specific mortality rate among 6 groups was significant (P<0.05), and progression and cancer-specific mortality rate between Ta and T1 stage was significant (P<0.05). Conclusion WHO2004 pathological classification of urothelial tumors could well reflect the outcome of the patients with bladder urothelial tumors and it is useful to estimate the tumors progress.