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全身分期计算机断层扫描在检测膀胱癌患者远处转移中的作用。

Role of whole-body staging computed tomographic scans for detecting distant metastases in patients with bladder cancer.

作者信息

Rajesh Arumugam, Sokhi Heminder, Fung Rachael, Mulcahy Kevin A, Bankart Michael J G

机构信息

Department of Radiology, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK.

出版信息

J Comput Assist Tomogr. 2011 May-Jun;35(3):402-5. doi: 10.1097/RCT.0b013e318214ad58.

Abstract

OBJECTIVE

This study aimed to establish the incidence of distant metastases on whole-body computed tomographic (CT) scans in patients with newly diagnosed bladder cancer and to determine whether there is a significant difference in the incidence of metastases in patients with superficial and muscle invasive cancers.

MATERIALS AND METHODS

A total of 201 patients who had a proven histological diagnosis of transitional cell carcinoma of the bladder and a whole-body staging CT scan at diagnosis were identified from our MDT database during a 36-month period. Imaging was retrospectively reviewed with view to recording site, if any, of distant metastases.

RESULTS

Of 201 patients, 11 (5.5%) were found to have distant metastases on CT. In univariable models, staging was not associated with either age (odds ratio, 0.98; 95% confidence interval, 0.92-1.04; P = 0.4) or sex (Fisher exact test, P = 0.07). Mean (SD) age was 74.1 (10.5) years. There was a significant association between staging and metastasis (odds ratio, 19.9; 95% confidence interval, 3.2-infinity; P = 0.0003). Of the patients, 7% of males had metastases versus 0% of the females.

CONCLUSIONS

Staging CT scans for assessment of distant metastatic disease in patients with newly diagnosed bladder cancer can be restricted to patients with muscle invasive disease.

摘要

目的

本研究旨在确定新诊断膀胱癌患者全身计算机断层扫描(CT)上远处转移的发生率,并确定浅表性癌和肌层浸润性癌患者转移发生率是否存在显著差异。

材料与方法

在36个月期间,从我们的多学科诊疗(MDT)数据库中识别出201例经组织学确诊为膀胱移行细胞癌且诊断时进行了全身分期CT扫描的患者。对影像进行回顾性分析,以记录远处转移的部位(如有)。

结果

201例患者中,11例(5.5%)在CT上发现有远处转移。在单变量模型中,分期与年龄(比值比,0.98;95%置信区间,0.92 - 1.04;P = 0.4)或性别(Fisher精确检验,P = 0.07)均无关联。平均(标准差)年龄为74.1(10.5)岁。分期与转移之间存在显著关联(比值比,19.9;95%置信区间,3.2 - 无穷大;P = 0.0003)。患者中,7%的男性有转移,而女性为0%。

结论

对于新诊断膀胱癌患者,用于评估远处转移性疾病的分期CT扫描可仅限于肌层浸润性疾病患者。

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