根治性膀胱切除术前淋巴结转移预测的相关指标分析

目的 探讨根治性膀胱切除术前临床指标在预测淋巴结转移方面的价值.方法 对2000年7月至2014年1月间在中山大学附属第三医院行根治性膀胱切除加盆腔淋巴结清扫术的67例患者进行回顾性分析,利用Logistic regression分析明确术前预测淋巴结转移的临床指标,并采用受试者操作曲线（ROC）来确定预测指标的临床应用价值.结果 入组患者中存在淋巴结转移的共计10例（14.9％）.术前经尿道膀胱肿瘤电切术（TUR）病理分级、术前CT中淋巴结大小作为独立的临床指标与术后的淋巴结转移有密切的关系,与其他指标相比具有统计学差异（P＜0.05）.ROC分析明确术前TUR病理分级、术前CT中淋巴结大小曲线下面积（AUC）分别为0.378（95％CI 0.194～0.562）,0.76 （95％CI 0.569～0.950）.结论 术前TUR病理分级以及影像学中淋巴结大小作为独立的预测指标,能为淋巴结转移判断提供可靠的依据.

Precystectomy nomograms for prediction of lymph node metastases

Objective To evaluate precystectomy nomograms prediction of lymph node metastases at cystectomy.Methods Clinical data of 67 radical cystectomy with pelvic lymphadenectomy cases were analyzed retrospectively.Logistic regression model assessed the value of the clinical nomograms.The area under the receiver operating characteristics （ROC） curve quantified the clinical value of these nomograms.Results Overall,10 （14.9%） patients had lymph node metastases.The analysis demonstrated that clinical tumor grade at transurethral resetion （TUR） and size of lymph nodes on CT were independent prediction nomograms of lymph node metastases at cystectomy （P〈0.05）.ROC analysis showed the area under the curve （AUC） of the two nomograms were 0.378 （95% CI 0.194-0.562）,0.76 （95% CI 0.569-0.950）,respectively.Conclusion Clinical tumor grade at TUR and size of lymph nodes on imagings were independent nomograms to predict lymph node metastases at cystectomy.