膀胱癌侵犯前列腺的相关因素研究

目的 探讨膀胱癌侵犯前列腺的相关因素,为保留患者前列腺的相关研究提供一些临床依据.方法回顾性分析135例膀胱癌患者的临床资料,采用Logistic逐步回归法分析膀胱癌侵犯前列腺的影响因素.结果135例患者中,14例(10.4%)患者出现膀胱癌侵犯前列腺.多因素分析结果显示,肿瘤部位、肿瘤直径、肿瘤与膀胱颈口距离、肿瘤分级是膀胱癌侵犯前列腺的独立影响因素.肿瘤位于膀胱三角区或颈部的患者发生膀胱癌侵犯前列腺的风险是非膀胱三角区或颈部患者的1.784倍;肿瘤直径每增大1 cm,患者出现膀胱癌侵犯前列腺的风险增大2.375倍;肿瘤与膀胱颈口距离每降低1 cm,患者出现膀胱癌侵犯前列腺的风险增大2.079倍;高级别肿瘤患者发生膀胱癌侵犯前列腺的风险是低级别肿瘤患者的1.684倍.结论 肿瘤位于膀胱三角区或颈部、肿瘤与膀胱颈口的距离较近、肿瘤高级别和肿瘤较大是膀胱癌患者前列腺受侵犯的高危因素,要重点加强对这类人群的观察,注意手术范围.

Study on the related factors of bladder cancer that invades prostate

Objective To explore the factors related to the invasion in prostate in patients with bladder cancer,and to lay the clinical basis for the preservation of prostate.Method 135 patients were enrolled in this retrospective study,and the factors associated with prostate invasion in bladder cancer were analyzed by Logistic stepwise regression. Result Among the 135 patients,there were 14(10.4%)patients with prostate invasion.In multivariate analysis,tumor site,tumor diameter,distance of tumor from bladder neck,and tumor grading were independent risk factors of prostate invasion in bladder cancer. Compared with tumors not in trigone or neck, those in trigone or neck of bladder were associated with 1.784 times of increased risk of prostate invasion;every 1 cm increase of tumor diameter indicated 2.375 times of higher risk of prostate invasion;while as the distance of tumor from the bladder neck decreased every 1 cm,the risk of prostate invasion would increase 2.079 times;the risk of invasion in patients with higher grade of bladder cancer was 1.684 times that of patients with lower grade of disease.Conclusion Tumor located in the bladder trigone or neck,tumor close to bladder neck, higher grade of disease, and tumor with greater diameter are the main risk factors of prostate invasion, which should be addressed in monitoring,and in selecting the scope of surgery.