非肌层浸润性膀胱癌行初次经尿道膀胱肿瘤电切术的术后复发危险因素分析

doi:10.20223/j.cnki.1000-8535.2025.03.017

摘要/Abstract

摘要： 目的探讨非肌层浸润性膀胱癌患者初次经尿道膀胱肿瘤电切术的复发情况及危险因素。方法以93例非肌层浸润性膀胱癌患者进行研究,2018年1月至2022年1月西藏自治区人民政府驻成都办事处医院泌尿外科医院收治采取经尿道膀胱肿瘤电切术,术后随访24个月,复发22例,未复发71例,比较复发与未复发基础情况、不同肿瘤直径、不同肿瘤分期、分级、数量、是否带蒂、灌注化疗方式等特征患者的复发情况,对具有统计学意义的因素,采取非条件Logistic多因素回归分析,明确术后复发的危险因素。结果肿瘤分期T1期者的复发率为32.08%,高于Ta期者15.50%,肿瘤分级为高级别者的复发率为53.33%,高于低级别者17.95%,肿瘤多发者的复发率为35.71%,高于单发者的13.73%,肿瘤不带蒂者的复发率为38.71%,高于肿瘤带蒂者的16.13%,常规灌注化疗患者的复发率为29.85%,高于术后即刻+灌注化疗患者的7.69%,比较差异均有统计学意义（χ²分别为6.648、4.836、6.872、6.166、5.834、5.902,P分别为0.010、0.027、0.008、0.013、0.015、0.024）。肿瘤分期T1期、肿瘤分级为高级别、肿瘤多发、常规灌注化疗为非肌层浸润性膀胱癌行初次经尿道膀胱肿瘤电切术的术后复发的危险因素（P<0.05）。结论非肌层浸润性膀胱癌患者初次采取经尿道膀胱肿瘤电切术容易因为临床分期为T1期、肿瘤分级为高级别、肿瘤多发及常规灌注等出现复发,应采取针对性干预措施,改进灌注化疗方式,降低复发率。

关键词: 非肌层浸润性膀胱癌, 经尿道膀胱肿瘤电切术, 复发, 危险因素

Abstract: Objective To investigate the relapse and risk factors of non-muscular invasive bladder cancer after primary transurethral resection．Methods A total of 93 patients with non-muscular invasive bladder cancer were selected for study．They were received by the hospital from January 2018 to January 2022 and underwent transurethral resection．After 24 months of follow-up,22 patients recurred,and 71 patients did not recur．The recurrence of patients with different tumor diameter,tumor stage,grade,numbers,pedicel or not,and infusion chemotherapy methods were compared．For the statistically significant factors,unconditional logistic regression analysis was used to determine the independent risk factors for recurrence．Results The recurrence rate in T1 stage of tumor was 32.08% higher than that in Ta stage,which was 15.50%．The recurrence rate in high stage was 53.33% higher than that in low stage,which was 17.95%．The recurrence rate in multiple tumor patients was 35.71% higher than that in single tumor patients,which was 13.73%．The no-pedicle tumor recurrence rate was 38.71% higher than that with pedicle,which was 16.13%．The recurrence rate in patients receiving conventional infusion chemotherapy was 29.85% higher than that in patients receiving immediate postoperative infusion chemotherapy,which was 7.69%．The differences were statistically significant（χ²=6.648、4.836、6.872、6.166、5.834、5.902,P=0.010、0.027、0.008、0.013、0.015、0.024）．The independent risk factors of recurrence after primary transurethral resection were tumor stage T1,high grade tumors,multiple tumors,routine perfusion chemotherapy as non-muscular invasive bladder cancer（P<0.05）．Conclusions The patients with non-muscular invasive bladder cancer taking transurethral resection for the first time are prone to recurrence because of the clinical stage of T1,tumor grade of high grade,multiple tumors and routine perfusion．Targeted intervention measures should be taken to improve the perfusion chemotherapy method to reduce the recurrence rate．

Key words: non-muscular invasive bladder cancer, transurethral resection of bladder tumors, recurrence, risk factors

桂豪军, 马保敬, 王二宾. 非肌层浸润性膀胱癌行初次经尿道膀胱肿瘤电切术的术后复发危险因素分析[J]. 广州医药, 2025, 56(3): 393-397.

GUI Haojun, MA Baojing, WANG Erbin. Risk factors for relapse after primary transurethral resection on non-muscular invasive bladder cancer[J]. Guangzhou Medical Journal, 2025, 56(3): 393-397.

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