Department IV, Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan.
Division of Nephrology, Department of Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.
Nephron. 2019;142(3):208-215. doi: 10.1159/000499081. Epub 2019 Mar 28.
Screening for hematuria is essential during health checkups in the general population. However, urine examinations in patients with cancer tend to be overlooked. This study attempted to demonstrate the novel utility of urinalysis in the assessment of the prognosis of non-Hodgkin lymphoma (NHL).
A longitudinal, retrospective cohort study was conducted to examine the association between hematuria and mortality in 294 patients with NHL. Urinalysis was performed using a dipstick test. A multivariate, logistic regression model was constructed to evaluate factors associated with the presence of hematuria. Statistical association between hematuria and the time to all-cause mortality was analyzed using Kaplan-Meier analysis, followed by multivariate proportional hazards regression analysis adjusted for covariates that might be related to mortality.
The prevalence of hematuria alone and in combination with proteinuria was 11.6 and 5.1%, respectively. C-reactive protein was a significant factor associated with the presence of hematuria (OR [95% CI] 1.17 [1.03-1.34], p = 0.0194). The cumulative mortality was significantly higher in patients with hematuria alone (51.1%), proteinuria alone (47.1%), and both (66.7%), than in those with neither (24.3%). Moreover, the presence of hematuria alone was significantly associated with all-cause mortality (hazard ratio [95% CI] 1.78 [1.10-3.50], p = 0.0455), and patients with concomitant proteinuria were at the highest risk (4.01 [1.71-8.33], p = 0.0001).
In patients with hematuric NHL, systemic inflammation is likely to develop to such a great extent that kidney damage occurs. Therefore, the presence of hematuria, alone or especially in combination with proteinuria, predicts a poor prognosis of NHL.
在普通人群的健康检查中，筛查血尿至关重要。然而，癌症患者的尿液检查往往被忽视。本研究试图证明尿液分析在评估非霍奇金淋巴瘤（NHL）预后方面的新用途。
进行了一项纵向、回顾性队列研究，以检查 294 例 NHL 患者血尿与死亡率之间的关系。使用尿试纸条试验进行尿液分析。构建了多变量逻辑回归模型来评估与血尿相关的因素。使用 Kaplan-Meier 分析评估血尿与全因死亡率之间的统计学关联，然后使用多变量比例风险回归分析调整可能与死亡率相关的协变量。
血尿单独和血尿合并蛋白尿的患病率分别为 11.6%和 5.1%。C 反应蛋白是血尿存在的显著相关因素（OR [95%CI] 1.17 [1.03-1.34]，p = 0.0194）。仅血尿（51.1%）、仅蛋白尿（47.1%）和血尿合并蛋白尿（66.7%）患者的累积死亡率明显高于无血尿和蛋白尿的患者（24.3%）。此外，仅血尿与全因死亡率显著相关（风险比 [95%CI] 1.78 [1.10-3.50]，p = 0.0455），同时伴有蛋白尿的患者风险最高（4.01 [1.71-8.33]，p = 0.0001）。
在血尿性 NHL 患者中，全身性炎症可能发展到如此严重的程度，以致发生肾损伤。因此，血尿的存在，无论是单独存在还是与蛋白尿联合存在，均预测 NHL 的预后不良。
