初次经尿道膀胱肿瘤电切术后肿瘤残留的多因素分析

摘要

Objective To investigate the related influencing facors for residual tumor after first transurethral resection of bladder tumor(TURBt),and to provide references for the clinical diagnosis and treatment .Methods A retrospective analysis was performed in the 98 patients with non-muscle invasive bladder cancer ( NMIBC ) after first TURBt,and the patients accepted re-TURBt or open surgery 2 to 6 weeks after first TURBt .The association between residual tumor and clinicopathologic variables was evaluated by Chi-sguare test and multivariate logistic regression analysis.Results After first TURBt,residual tumor was present in 6 of 39(15.38%) patients with Ta bladder cancer and in 19 of 49(38.78%) patients with T1 bladder cancer.Chi-sguare test suggested that the number of tumor ,pathological type of tumor and transurethral device were not associated with residual tumor (P>0.05),but the tumor size,position of tumor,growing pattern of tumor,tumor grade,tumor stage,method of transurethral resection and the operator′s experience were associated with residual tumor ( P<0.05).The results of multivariate logistic regression analysis showed that tumor grade ,tumor stage and the growing pattern of tumor were the major related factors .Conclusion The related influencing factors for residual tumor of bladder cancer include tumor size ,position of tumor ,growing pattern of tumor ,tumor grade , tumor stage ,method of transurethral resection and the operator′s experience .%目的：探讨初次经尿道膀胱肿瘤电切术（ TURBt）术后肿瘤残留的相关影响因素，为临床诊治提供参考。方法回顾性分析98例非肌层浸润膀胱癌（ NMIBC ）实施TURBt术并于术后2～6周内行re-TURBt或开放手术膀胱癌患者的临床病理资料，采用χ2检验及多因素logistic回归分析相关临床病理因素与肿瘤残留的关系。结果初次TURBt术后39例Ta期肿瘤残留6例（15．38％），49例T1期肿瘤残留19例（38．78％）。相关分析显示肿瘤数目、组织病理类型、电切设备与肿瘤残留无关（P＞0．05），而肿瘤大小、位置、生长方式、分级、分期、电切方法、术者经验与肿瘤残留相关（ P＜0．05）。 logistic多因素回归分析得出肿瘤分级、分期、生长方式为主要相关因素。结论影响初次TURBt术后肿瘤残留的相关因素有肿瘤大小、肿瘤位置、生长方式、分级、分期、电切方法、术者经验等。