Miyazaki Jun, Nishiyama Hiroyuki, Fujimoto Hiroyuki, Ohyama Chikara, Koie Takuya, Hinotsu Shiro, Kikuchi Eiji, Sakura Mizuaki, Inokuchi Junichi, Hara Tomohiko
Working Group of the UTUC Registration Committee of the Japanese Urological Association, Tokyo, Japan.
Department of Urology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
Int J Urol. 2015 Nov;22(11):1023-7. doi: 10.1111/iju.12886. Epub 2015 Aug 4.
To examine the influence of smoking history on the diagnosis and other tumor characteristics of upper tract urothelial carcinoma in Japan.
A total of 1509 patients with upper tract urothelial carcinoma who were diagnosed in 2005 from 348 Japanese institutions were registered using the multi-institutional national database of the Japanese Urological Association and included in this analysis. Clinical data of the patients were collected in 2011. The associations between the patients' self-reported smoking history and their age at the diagnosis of upper tract urothelial carcinoma, sex, pathological T stage and tumor grade were analyzed.
The mean age at the diagnosis of upper tract urothelial carcinoma was approximately 5 years earlier for the 238 current smokers than for the 618 current non-smokers (P < 0.0001). Similar associations between smoking and the early diagnosis of upper tract urothelial carcinoma were shown in the sex subgroups and in subgroups stratified by pathological T stages. Among the current smokers, the age at diagnosis for the smoking ≥ 20 cigarettes per day group was 6.5 years lower than that of the < 20 cigarettes per day group, which was significantly different (P < 0.0001).
Current smoking is a significant risk factor for the earlier diagnosis of upper tract urothelial carcinoma. The finding is important from the perspective of both healthcare and medical economies.
探讨吸烟史对日本上尿路尿路上皮癌诊断及其他肿瘤特征的影响。
利用日本泌尿外科学会的多机构全国数据库，登记了2005年在日本348家机构诊断出的1509例上尿路尿路上皮癌患者，并纳入本分析。于2011年收集患者的临床资料。分析患者自我报告的吸烟史与上尿路尿路上皮癌诊断时的年龄、性别、病理T分期及肿瘤分级之间的关联。
238名当前吸烟者诊断上尿路尿路上皮癌时的平均年龄比618名当前非吸烟者早约5年（P<0.0001）。在性别亚组和按病理T分期分层的亚组中，吸烟与上尿路尿路上皮癌的早期诊断之间也显示出类似的关联。在当前吸烟者中，每天吸烟≥20支组的诊断年龄比每天吸烟<20支组低6.5岁，差异有统计学意义（P<0.0001）。
当前吸烟是上尿路尿路上皮癌早期诊断的一个重要危险因素。从医疗保健和医疗经济的角度来看，这一发现都很重要。
