Antunes Alberto A, Nesrallah Luciano J, Dall'Oglio Marcos F, Maluf Carlos E, Camara Cesar, Leite Katia R, Srougi Miguel
Division of Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil and Hospital Sìrio Libanes, Sao Paulo, Brazil.
Int Braz J Urol. 2007 May-Jun;33(3):339-45; discussion 346. doi: 10.1590/s1677-55382007000300006.
We aim at determining the prognostic value of squamous differentiation in patients with transitional cell carcinoma (TCC) of the bladder that were treated with radical cystectomy.
From January 1993 to January 2005, we retrospectively selected 113 patients. Correlations among squamous differentiation with other clinical and pathological features were assessed by both chi-square and Fisher tests. The Kaplan-Meier method was used to evaluate survival curves and statistical significance was determined by the log-rank test. Multivariate analysis was performed through a Cox proportional hazards regression model.
Squamous differentiation was observed in 25 (22.1%) of the 113 patients. This finding was significantly related only to the pathological stage. Mean follow-up after cystectomy was 31.7 +/- 28.5 months. Disease recurrence occurred in 16 (64%) and 30 (34%) patients with and without squamous differentiation (log-rank test, p = 0.001), and mortality occurred in 10 (40%) and 14 (16%) of the patients with and without squamous differentiation respectively. Univariate analysis revealed that pathological stage, squamous differentiation, tumor size and lymph node involvement were significant predictors of cancer-specific survival. However, only squamous differentiation and tumor size were independent prognostic variables on multivariate analysis.
Squamous differentiation was an independent prognostic factor for cancer specific survival in patients with bladder cancer treated with radical cystectomy. Further studies with a larger number of patients are necessary to confirm these results.
我们旨在确定接受根治性膀胱切除术治疗的膀胱移行细胞癌（TCC）患者中鳞状分化的预后价值。
从1993年1月至2005年1月，我们回顾性选取了113例患者。通过卡方检验和费舍尔检验评估鳞状分化与其他临床及病理特征之间的相关性。采用Kaplan-Meier法评估生存曲线，并通过对数秩检验确定统计学意义。通过Cox比例风险回归模型进行多变量分析。
113例患者中有25例（22.1%）观察到鳞状分化。这一发现仅与病理分期显著相关。膀胱切除术后的平均随访时间为31.7±28.5个月。有和无鳞状分化的患者中分别有16例（6�%）和30例（34%）出现疾病复发（对数秩检验，p = 0.001），有和无鳞状分化的患者中分别有10例（40%）和14例（16%）死亡。单变量分析显示，病理分期、鳞状分化、肿瘤大小和淋巴结受累是癌症特异性生存的显著预测因素。然而，多变量分析显示只有鳞状分化和肿瘤大小是独立的预后变量。
鳞状分化是接受根治性膀胱切除术治疗的膀胱癌患者癌症特异性生存的独立预后因素。需要更多患者的进一步研究来证实这些结果。
