Jakus Dora, Šolić Ivana, Jurić Ivan, Borovac Josip A, Šitum Marijan
Department of Urology, University Hospital Center Split, 21000 Split, Croatia.
Clinic for Heart and Vascular Diseases, University Hospital Center Split, 21000 Split, Croatia.
J Clin Med. 2023 Jun 25;12(13):4259. doi: 10.3390/jcm12134259.
This study investigated the impact of the initial clinical presentation of bladder cancer on tumor characteristics. A cross-sectional, retrospective study was performed, and it involved 515 patients who underwent transurethral bladder cancer resection at the University Hospital Center Split between April 2019 and April 2023, excluding recurrent cases. The association between symptomatic versus asymptomatic presentation and bladder cancer characteristics was analyzed. A subgroup analysis compared tumor characteristics between patients with gross and microscopic hematuria. Multiple regression analyses revealed a significant association between symptomatic presentation and the detection of high-grade bladder cancer (OR 3.43, 95% CI 2.22-5.29, < 0.001), concomitant CIS (OR 3.41, 95% CI 1.31-8.88, = 0.012), T2 stage bladder cancer (OR 5.79, 95% CI 2.45-13.71, < 0.001), a higher number of tumors (IRR 1.24, 95% CI 1.07-1.45, = 0.005), and larger tumor size (B 1.68, 95% CI 1.19-2.18, < 0.001). In the subgroup analysis, gross hematuria was associated with the detection of high-grade bladder cancer (OR 2.07, 95% CI 1.12-3.84, = 0.020), T2 stage bladder cancer (OR 6.03, 95% CI 1.42-25.49, = 0.015), and larger tumor size (B 1.8, 95% CI 0.99-2.6, < 0.001). The identified associations between symptomatic presentation and unfavorable bladder cancer characteristics, likely attributed to early detection in asymptomatic cases, underscore the importance of additional research in the development of bladder cancer screening strategies.
本研究调查了膀胱癌的初始临床表现对肿瘤特征的影响。进行了一项横断面回顾性研究，研究对象为2019年4月至2023年4月期间在斯普利特大学医院中心接受经尿道膀胱癌切除术的515例患者，不包括复发病例。分析了有症状与无症状表现与膀胱癌特征之间的关联。亚组分析比较了肉眼血尿和镜下血尿患者的肿瘤特征。多元回归分析显示，有症状表现与高级别膀胱癌的检出之间存在显著关联（比值比3.43，95%置信区间2.22 - 5.29，P < 0.001）、伴发原位癌（比值比3.41，95%置信区间1.31 - 8.88，P = 0.012）、T2期膀胱癌（比值比5.79，95%置信区间2.45 - 13.71，P < 0.001）、肿瘤数量较多（发病率比值1.24，95%置信区间1.07 - 1.45，P = 0.005）以及肿瘤尺寸较大（β 1.68，95%置信区间1.19 - 2.18，P < 0.001）。在亚组分析中，肉眼血尿与高级别膀胱癌的检出（比值比2.07，95%置信区间1.12 - 3.84，P = 0.020）、T2期膀胱癌（比值比6.03，95%置信区间1.42 - 25.49，P = 0.015）以及肿瘤尺寸较大（β 1.8，95%置信区间0.99 - 2.6，P < 0.001）相关。有症状表现与不良膀胱癌特征之间确定的关联，可能归因于无症状病例的早期检测，这突出了在膀胱癌筛查策略制定方面进行更多研究的重要性。
