Corrado F, Ferri C, Mannini D, Corrado G, Bertoni F, Bacchini P, Lelli G, Lieber M M, Song J M
Divisione di Urologia I and Oncologia, Ospedale Malpighi, Bologna, Italy.
J Urol. 1991 Jun;145(6):1159-63. doi: 10.1016/s0022-5347(17)38562-2.
Prognostic factors in transitional cell carcinoma of the upper urinary tract were assessed with histopathological examination and flow cytometric analysis in a series of 127 patients operated upon between 1976 and 1988. In particular, we evaluated the usefulness of flow cytometry to identify patients who require adjuvant treatment among those with low grade and low stage disease (51% in this series). A multivariate analysis was done on 92 cases, considering patient age and sex, stage, grade and number of lesions (unifocal versus multifocal), site (renal pelvis versus ureter), presence of vesical tumors, recurrences along the urinary tract or in the bladder, type of operation and nuclear deoxyribonucleic acid (DNA) ploidy (diploid versus tetraploid/aneuploid tumors). Only the stage (p = 0.001), grade (p = 0.001) and, to a lesser extent, the DNA pattern (p = 0.031), as well as the number of lesions (p = 0.061) were determinant for prognosis. In regard to the subgroup of 41 patients with grade 2 or less, stage P1 or less tumors, no significant difference in survival was demonstrated between diploid and nondiploid tumor patients. However, 7 of 10 patients from the latter group are still under observation. Therefore, our conclusions may have to be modified in the future.
对1976年至1988年间接受手术的127例上尿路移行细胞癌患者进行了组织病理学检查和流式细胞术分析，以评估其预后因素。特别是，我们评估了流式细胞术在识别低级别和低分期疾病患者（本系列中占51%）中需要辅助治疗的患者方面的实用性。对92例患者进行了多变量分析，考虑了患者的年龄和性别、分期、分级、病变数量（单灶性与多灶性）、部位（肾盂与输尿管）、膀胱肿瘤的存在、尿路或膀胱中的复发情况、手术类型以及核脱氧核糖核酸（DNA）倍性（二倍体与四倍体/非整倍体肿瘤）。只有分期（p = 0.001）、分级（p = 0.001）以及在较小程度上DNA模式（p = 0.031）和病变数量（p = 0.061）是预后的决定因素。对于41例肿瘤分级为2级或更低、分期为P1或更低的患者亚组，二倍体和非二倍体肿瘤患者的生存率没有显著差异。然而，后一组中的10例患者中有7例仍在观察中。因此，我们的结论可能在未来不得不进行修改。
