Subramonian K, Cartwright R A, Harnden P, Harrison S C W
Department of Urology, Pinderfields Hospital, Aberford Road, Wakefield, West Yorkshire WF1 4DG, UK.
BJU Int. 2004 Apr;93(6):739-43. doi: 10.1111/j.1464-410X.2003.04718.x.
To evaluate the age-standardized incidence rate of bladder cancer in patients with spinal cord injury (SCI) and the overall risk for this population.
We reviewed 1334 patients with SCI whose dates of SCI, or first attendance at our centre, were between 1940 and 1998. The length of follow-up was calculated for each patient and age-specific incidence rates of bladder cancer calculated using 5-year age bands. This was used to calculate the overall incidence rate, using direct standardization with the European standard population. The cancers were analysed histochemically to characterize the phenotype.
The 1324 patients contributed a total of 12 444 person-years of follow-up. There were four cases of bladder cancer, giving an age-standardized incidence rate of 30.7 per 100 000 person-years. Histochemistry showed areas were positive for cytokeratin 14, which was also positive in the undifferentiated areas. Immunohistochemical staining was positive for cytokeratin 14 and consistently negative for cytokeratin 20, suggesting a pure squamous phenotype.
The age-standardized incidence of invasive bladder cancer in patients in our SCI unit is not statistically different from that of the general population. However, the incidence of invasive bladder cancer in the present study appears to be lower than that reported in other series. Histochemical analysis confirmed a squamous cell phenotype in these tumours.
评估脊髓损伤（SCI）患者膀胱癌的年龄标准化发病率以及该人群的总体风险。
我们回顾了1334例SCI患者，其SCI日期或首次到我们中心就诊的日期在1940年至1998年之间。计算每位患者的随访时长，并使用5岁年龄组计算膀胱癌的年龄特异性发病率。采用欧洲标准人群直接标准化法来计算总体发病率。对癌症进行组织化学分析以表征其表型。
1324例患者的总随访人年数为12444人年。有4例膀胱癌病例，年龄标准化发病率为每10万人年30.7例。组织化学显示，细胞角蛋白14在某些区域呈阳性，在未分化区域也呈阳性。免疫组织化学染色显示细胞角蛋白14呈阳性，细胞角蛋白20始终呈阴性，提示为纯鳞状表型。
我们的SCI科室患者浸润性膀胱癌的年龄标准化发病率与普通人群无统计学差异。然而，本研究中浸润性膀胱癌的发病率似乎低于其他系列报道的发病率。组织化学分析证实这些肿瘤为鳞状细胞表型。
