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淋巴管侵犯对T1期膀胱癌短期肿瘤复发和进展的影响。

The Effect of Lymphovascular Invasion on Short-Term Tumor Recurrence and Progression in Stage T1 Bladder Cancer.

作者信息

Gercek Osman, Senkol Melih, Yazar Veli Mert, Topal Kutay

机构信息

Urology, Afyonkarahisar Health Sciences University, Afyonkarahisar, TUR.

Urology, Afyonkarahisar State Hospital, Afyonkarahisar, TUR.

出版信息

Cureus. 2024 Feb 24;16(2):e54844. doi: 10.7759/cureus.54844. eCollection 2024 Feb.

Abstract

Introduction Lymphovascular invasion (LVI) is the most important stage for tumor spread and metastasis. The role of LVI in transurethral resection is not yet clear. In this study, the progression and recurrences of patients who underwent transurethral resection bladder tumor (TUR-BT) and T1 high-grade tumor and concomitant LVI were detected in pathology results and were evaluated. Methods Our study included 58 patients, who underwent TUR-BT with the suspicion of bladder cancer and were pathologically diagnosed with T1 stage bladder cancer and who did not undergo radical surgery, in the Urology Clinic of Afyonkarahisar Health Sciences University, Turkey. The patient's age, gender, tumor size, tumor grade, presence of LVI, second resection, recurrence, and progression rates at three months and one year were compared. Results LVI was detected in the pathology specimens of nine (15.5%) of the 58 patients who were included in the study. When the one-year progression was evaluated, progression to T2 tumor was detected in six (66.7%) patients in the group with LVI and five (10.2%) patients in the group without LVI, and the progression was significantly higher in the group with LVI (p=0.001). In logistic regression analysis, the only significant predictor for one-year progression was the presence of LVI (p=0.001). Conclusion According to the results of our study, the presence of LVI in the pathology specimens of patients with T1 high grade significantly increases the progression. Suggesting radical cystectomy and neoadjuvant chemotherapy to patients with LVI in the early period seems to be a more accurate approach, considering the course of the disease.

摘要

引言

淋巴管浸润(LVI)是肿瘤扩散和转移的最重要阶段。LVI在经尿道切除术中的作用尚不清楚。在本研究中,对接受经尿道膀胱肿瘤切除术(TUR-BT)的T1期高级别肿瘤且伴有LVI的患者的病情进展和复发情况进行了病理结果检测和评估。

方法

我们的研究纳入了58例患者,这些患者在土耳其阿菲永卡拉希萨尔健康科学大学泌尿外科门诊因疑似膀胱癌接受了TUR-BT,病理诊断为T1期膀胱癌且未接受根治性手术。比较了患者的年龄、性别、肿瘤大小、肿瘤分级、LVI的存在情况、二次切除情况、复发情况以及三个月和一年时的进展率。

结果

在纳入研究的58例患者中,有9例(15.5%)的病理标本中检测到LVI。在评估一年进展情况时,LVI组中有6例(66.7%)患者进展为T2期肿瘤,无LVI组中有5例(10.2%)患者进展为T2期肿瘤,LVI组的进展率显著更高(p = 0.001)。在逻辑回归分析中,一年进展的唯一显著预测因素是LVI的存在(p = 0.001)。

结论

根据我们的研究结果,T1期高级别患者病理标本中LVI的存在显著增加了病情进展。考虑到疾病的进程,对于早期有LVI的患者建议行根治性膀胱切除术和新辅助化疗似乎是一种更准确的方法。

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