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分析非肌层浸润性膀胱癌患者卡介苗诱导性前列腺炎的危险因素。

Analysis of risk factors for post-bacillus Calmette-Guerin-induced prostatitis in patients with non-muscle invasive bladder cancer.

机构信息

Department of Urology, CHA University College of Medicine, CHA Bundang Hospital, Seoul, Korea.

Department of Radiology, Seoul National University Bundang Hospital, Seoul, Korea.

出版信息

Sci Rep. 2020 Jun 17;10(1):9763. doi: 10.1038/s41598-020-66952-4.

Abstract

The objective of this study was to evaluate risk factors for bacillus Calmette-Guerin-induced prostatitis in patients with non-muscle invasive bladder cancer following bacillus Calmette-Guerin therapy. Clinical findings from patients with non-muscle invasive bladder cancer who underwent multi-parametric magnetic resonance imaging before transurethral resection of bladder tumor and post-bacillus Calmette-Guerin therapy from March 2004 to August 2018 were evaluated. The population was grouped into patients with or without newly developed lesions on multi-parametric magnetic resonance imaging performed 3 months after bacillus Calmette-Guerin instillation. Patients with prostate-specific antigen levels ≥ 4 ng/mL or prostate cancer were excluded. Univariable and multivariable analyses were performed to determine the predictors of prostate lesions in patients with prior bacillus Calmette-Guerin exposure. Post bacillus Calmette-Guerin-induced prostatitis was found in 50 of the 194 patients (25.8%). No significant differences were observed between the groups except for prostate volumes (33.8 mL vs. 30.8 mL, P = 0.012) and body mass index (25.2 kg/m vs. 24.1 kg/m, P = 0.044). After bacillus Calmette-Guerin exposure, no significant differences in prostate-specific antigen levels, international prostate symptom scores, or post-voiding residual volume were noted. Multivariable regression analysis showed that body mass index (odds ratio, OR = 1.115, P = 0.038) and prostate volume (OR = 3.080, P = 0.012) were significant predictors of post-bacillus Calmette-Guerin prostate lesions. Body mass index and prostate volume may be clinical predictors of prostate lesions after bacillus Calmette-Guerin exposure. Awareness of potential risk factors for this entity should contribute to the clinical decision-making process for patients following bacillus Calmette-Guerin therapy.

摘要

本研究旨在评估卡介苗诱导的前列腺炎的危险因素,这些患者患有非肌肉浸润性膀胱癌,在接受卡介苗治疗后。评估了 2004 年 3 月至 2018 年 8 月期间接受经尿道膀胱肿瘤切除术和卡介苗治疗后多参数磁共振成像的非肌肉浸润性膀胱癌患者的临床发现。人群分为在卡介苗注射后 3 个月进行多参数磁共振成像时新出现病变的患者和无新病变的患者。排除前列腺特异性抗原水平≥4ng/ml或前列腺癌的患者。进行单变量和多变量分析,以确定既往卡介苗暴露患者前列腺病变的预测因素。在 194 名患者中发现 50 名(25.8%)患有卡介苗诱导的前列腺炎。除前列腺体积(33.8ml 与 30.8ml,P=0.012)和体重指数(25.2kg/m 与 24.1kg/m,P=0.044)外,两组之间无显著差异。在卡介苗暴露后,前列腺特异性抗原水平、国际前列腺症状评分或排尿后残余量无显著差异。多变量回归分析显示,体重指数(比值比,OR=1.115,P=0.038)和前列腺体积(OR=3.080,P=0.012)是卡介苗后前列腺病变的显著预测因素。体重指数和前列腺体积可能是卡介苗暴露后前列腺病变的临床预测因素。了解该实体的潜在危险因素有助于为接受卡介苗治疗的患者的临床决策过程做出贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2d5/7300010/e14be71dd879/41598_2020_66952_Fig1_HTML.jpg

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