Upper urinary tract urothelial cell carcinoma: location as a predictive factor for concomitant bladder carcinoma
Upper urinary tract urothelial cell carcinoma: location as a predictive factor for concomitant bladder carcinoma
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DOI：
10.1007/s00345-012-0877-2
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发表时间：
2013-02-01
影响因子：
3.4
通讯作者：
Villavicencio-Mavrich, Humberto
中科院分区：
文献类型：
--
作者：
Cosentino, Marco;Palou, Joan;Villavicencio-Mavrich, Humberto
探讨伴发、原发UUT-UCC和BC的预测因素的存在。上尿路尿路上皮细胞癌(UUT-UCC)是一种移行上皮细胞的泛尿路上皮病。虽然已有多项研究表明UUT-UCC术后膀胱癌复发之间存在关联，但对伴发UUT-UCC和无膀胱癌史的膀胱癌(BC)的发生率却知之甚少。排除有BC病史的患者。我们调查了年龄、性别、上尿路肿瘤的部位(肾盏、肾盂、输尿管上段、输尿管中段、输尿管下段)、多发灶、临床症状、肿瘤分级和病理分期。类别变量使用列联表和卡方检验，数量变量使用方差分析(ANOVA)。确定符合纳入条件的450名患者。其中，76例(17%)合并原发UUT-UCC和BC。原发UUT-UCC位于肾盏和/或肾盂25例(34%)，输尿管上段8例(11%)，输尿管下段37例(49%)。在6名患者(8%)中，数据丢失。原发性肾盏/肾盂、输尿管上段和输尿管下段UUT-UCC患者中，合并BC的比例分别为10%、18%和33%。多因素分析显示，输尿管移行细胞癌的位置是伴发膀胱癌的唯一预测因素(OR：1.70；95%CI，1.007~2.906 p=0.047)，提示初诊患者伴发膀胱癌的可能性高达33%，主要取决于上尿路肿瘤的位置。
To investigate the existence of predictive factors for concomitant, primary UUT-UCC and BC. Upper urinary tract urothelial cell carcinoma (UUT-UCC) is a pan-urothelial disease of the transitional epithelial cells. Although several studies have shown the association of bladder recurrence following UUT-UCC, little is known on the incidence of concomitant UUT-UCC and bladder cancer (BC) without previous BC.A retrospective review of 673 patients diagnosed and treated for UUT-UCC was performed. Patients with history of BC were excluded. We investigated age, sex, location of the upper tract tumor (calyx, renal pelvis, upper ureter, mid-ureter, lower ureter), multifocality, clinical symptoms, tumor grade and pathological stage. Contingency tables and chi-square test were used for categorical variables and analysis of variance (ANOVA) for quantitative variables.450 patients eligible for inclusion were identified. Of these, 76 (17 %) presented concomitant primary UUT-UCC and BC. Location of primary UUT-UCC was in calyx and/or renal pelvis in 25 patients (34 %), upper ureter 8 (11 %) and lower ureter 37 (49 %). In 6 patients (8 %), data were missing. Concomitant BC was found in 10, 18, and 33 % of patients with primary caliceal/renal pelvis, upper ureter and lower ureter UUT-UCC, respectively. On multivariate analysis, location of UUT-UCC was the only predictive factor for concomitant bladder tumor (OR: 1.7; 95 % CI, 1.007-2.906 p = 0.047).Our findings suggest that the possibility of concomitant BC in primary diagnosed patient with UUT-UCC is as high as 33 % and mainly depends on upper tract tumor location.