Kiyoshima Keijiro, Akitake Masakazu, Shiota Masaki, Takeuchi Ario, Takahashi Ryosuke, Inokuchi Junichi, Tatsugami Katsunori, Yokomizo Akira, Eto Masatoshi
Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
Anticancer Res. 2016 Feb;36(2):799-802.
To examine the clinical significance of preoperative urine cytology in patients with low-grade bladder cancer.
We retrospectively investigated the records of 155 patients diagnosed with primary low-grade (Ta) urothelial carcinoma of the bladder between January 2000 and September 2014.
Patients with class III or greater cytology had significantly higher-grade (G2) (p=0.01), larger tumors (≥15 mm, p=0.0009) and significantly shorter recurrence-free survival compared to patients with class II or lower cytology (p<0.0001). However, Cox proportional hazards analysis for recurrence-free survival only identified tumor size (≥15 mm) (hazard ratio=5.97, 95% confidence interval=2.39-17.29; p<0.0001) as a predictor of poor prognosis, although patients with class III or higher preoperative cytology showed a tendency towards frequent intravesical recurrence (hazard ratio=1.98, 95% confidence interval=0.96-4.2; p=0.063).
Preoperative urine cytology, in addition to tumor size, might be a useful predictor of intravesical recurrence of bladder cancer.
探讨术前尿液细胞学检查在低级别膀胱癌患者中的临床意义。
我们回顾性研究了2000年1月至2014年9月期间确诊为原发性低级别（Ta）膀胱尿路上皮癌的155例患者的记录。
与细胞学检查为II级或更低级别的患者相比，细胞学检查为III级或更高级别的患者肿瘤分级显著更高（G2）（p = 0.01），肿瘤更大（≥15 mm，p = 0.0009），无复发生存期显著更短（p < 0.0001）。然而，无复发生存期的Cox比例风险分析仅确定肿瘤大小（≥15 mm）（风险比=5.97，95%置信区间=2.39 - 17.29；p < 0.0001）是预后不良的预测因素，尽管术前细胞学检查为III级或更高的患者膀胱内复发倾向较高（风险比=1.98，95%置信区间=0.96 - 4.2；p = 0.063）。
除肿瘤大小外，术前尿液细胞学检查可能是膀胱癌膀胱内复发的有用预测指标。
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