输尿管癌预后相关因素的临床研究

目的探讨影响输尿管癌患者预后的重要因素。方法回顾性分析2001年1月至2005年12月133例接受手术治疗的原发输尿管癌患者的临床资料。结果在133例输尿管癌患者中,分期为Ta～T1的表浅输尿管癌42例（31．6％）,分期为12-T4的浸润性输尿管癌91例（68．4％）,肿瘤位于输尿管下段63例（47．4％）。数据显示越靠近输尿管下段的肿瘤较易呈浸润性生长。输尿管下段癌的生存率明显低于上、中段癌。多因素Cox生存率分析结果表明肿瘤的分级、分期与生存率密切相关。结论输尿管癌在输尿管下段好发,与膀胱癌不同,更容易呈浸润性生长,而且越接近输尿管下段的肿瘤分期越高。多因素Cox生存率分析表明输尿管癌的分级和分期是判断预后最重要的因素。

Study of prognostic factors of ureter cancer

OBJECTIVE: To evaluate the prognostic factors of ureter transitional cell carcinoma (TCC). METHODS: Between January 2001 and December 2005 133 TCC patients were treated. And the data was retrospectively analyzed. RESULTS: A mean age of the 133 patients was 68 years (range 43 - 87 years) at diagnosis. Altogether the non-invasive ureter TCC was found in 42 patients (31.6%) and the invasive ureter TCC in 91 patients (68.4%). Invasive ureter TCC growth was more common in distally located tumors (82.5%) compared to mid (62.5%) and proximal ureter (47.1%). Tumor stage, grade and location of the tumor were all correlated with disease specific survival in a univariate analysis. In a multivariate Cox analysis, tumor stage and grade were significantly associated with disease specific survival. CONCLUSIONS: More invasive tumors are found in ureter than in bladder. Ureter cancer is more frequently found in the distal part. Distally located ureteral tumors are more likely invading into the muscular cell layers compared to proximally located tumors. Tumor stage and grade are still the more important prognostic factors for ureter TCC.