膀胱移行细胞癌T1期复发的多因素分析

目的：探讨多种临床病理指标和生物学标志物在预测T1期膀胱移行细胞癌复发中的价值。方法：采用免疫组化SP法,对75例原发性T1期膀胱癌患者的3种生物学标记物p53、上皮钙黏附素(E-cadherin)和血管内皮生长因子(VEGF)的表达情况进行检测,通过Kaplan-Meier生存分析和Cox风险比例模型,评估各临床病理指标和生物学标记物对复发的影响。结果：患者的1,3,5年累计无复发生存率分别为68．0％、45．3％和20．9％。单因素生存分析显示,肿瘤的发生情况、p53、E-cadherin和VEGF的表达与复发有相关性。多因素分析提示,肿瘤的发生情况、p53和E-cadherin的表达与复发密切相关,而其他变量均与复发无关。结论：膀胱癌的多灶性、p53和E-cadherin的异常表达是预测T1期膀胱癌复发的独立指标。

Multivariate analysis of recurrence in T1 bladder transitional cell carcinoma

Objective To investigate the prognostic value of some clinicopathologic indexes and biologic tumor markers in predicting recurrence in T1 transitional cell carcinoma (TCC) of the bladder. Methods The expressions of p53, E-cadherin and VEGF of 75 patients with T1 primary bladder TCC were detected by streptabitin peroxidase (SP) immunohistochemical methods. The effects of clinicopathologic indexes and biologic tumor markers on recurrence were assessed by Kaplan-Meier and Cox proportional hazards model. Results The 1-, 3-, and 5- year recurrence- free survival rates were 68.0%, 45.3% and 20.9%. In Kaplan-Meier analysis, tumor mutifocality and the expression of p53, E-cadherin and VEGF were associated with recurrence. In multivariate analysis, the independent recurrence variables were tumor mutifocality, the expression of p53 and E-cadherin. Conclusion Tumor mutifocality and the abnormal expression of p53 and E-cadherin are the variables that indepently predict recurrence in T1 transitional cell carcinoma of the bladder.