Fujikawa K, Matsui Y, Oka H, Fukuzawa S, Sasaki M, Takeuchi H
Department of Urology, Kobe City General Hospital, Chuo-ku, Kobe City, Japan.
J Urol. 2000 Aug;164(2):352-5.
We compare estimates of volume weighted mean nuclear volume (MNV) with histological grading to determine the prognosis of primary transitional cell carcinoma of the upper urinary tract using a Cox proportional hazards model.
We retrospectively reviewed 102 patients who underwent nephroureterectomy for primary transitional cell carcinoma of the upper urinary tract at our hospital between April 1981 and March 1997. Traditional prognostic factors, such as patient age, sex, stage and grade, multiplicity and unbiased estimates of MNV were analyzed with respect to disease recurrence and survival.
Estimates of mean nuclear volume were significantly larger for patients with than without lymph node metastasis (p = 0.0031). No prognostic factor significantly correlated with recurrence of transitional cell carcinoma of the bladder. For pTxN0M0 cases univariate analysis revealed that histological grade (p = 0.0018), pathological T stage (p = 0.0030) and estimates of MNV (p = 0.0001) correlated significantly with disease specific survival, and multivariate stepwise regression analysis revealed that estimate of MNV was the only powerful predictor of prognosis (p = 0.0007).
Our results indicate that estimate of MNV is an important predictor of prognosis for transitional cell carcinoma of the upper urinary tract. We recommend MNV estimate as a supportive method for subjective histological grading.
我们使用Cox比例风险模型比较体积加权平均核体积（MNV）估计值与组织学分级，以确定上尿路原发性移行细胞癌的预后。
我们回顾性分析了1981年4月至1997年3月间在我院因上尿路原发性移行细胞癌接受肾输尿管切除术的102例患者。分析了患者年龄、性别、分期、分级、肿瘤多灶性等传统预后因素以及MNV的无偏估计值与疾病复发和生存的关系。
有淋巴结转移患者的平均核体积估计值显著大于无淋巴结转移患者（p = 0.0031）。没有预后因素与膀胱移行细胞癌的复发显著相关。对于pTxN0M0病例，单因素分析显示组织学分级（p = 0.0018）、病理T分期（p = 0.0030）和MNV估计值（p = 0.0001）与疾病特异性生存显著相关，多因素逐步回归分析显示MNV估计值是唯一有力的预后预测因素（p = 0.0007）。
我们的结果表明，MNV估计值是上尿路移行细胞癌预后的重要预测因素。我们建议将MNV估计作为主观组织学分级的辅助方法。
