Rajesh Arumugam, Sokhi Heminder, Fung Rachael, Mulcahy Kevin A, Bankart Michael J G
Department of Radiology, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK.
J Comput Assist Tomogr. 2011 May-Jun;35(3):402-5. doi: 10.1097/RCT.0b013e318214ad58.
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.
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.
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.
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.
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。
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）。
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%。
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。
