Department of Urology, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea.
Institute of Health Science, Gyeongsang National University, Jinju, Korea.
Investig Clin Urol. 2024 May;65(3):279-285. doi: 10.4111/icu.20230284.
To investigate the relationship between urine cytology results after overnight continuous saline irrigation (OCSI) following transurethral resection of bladder tumor (TURBT) and bladder tumor recurrence in non-muscle invasive bladder cancer (NMIBC).
A retrospective study was conducted on patients diagnosed with NMIBC between 2016 and 2020 after undergoing TURBT at our hospital. All patients received OCSI following TURBT and had urine cytology test at postoperative 1 day. Urine cytology was classified into three groups: Negative, low-grade urothelial neoplasm (LGUN)+atypical urothelial cells (AUC), and suspicious for high-grade urothelial carcinoma (SHGUC)+high-grade urothelial carcinoma (HGUC). Recurrence-free survival (RFS) in each group was compared using the Kaplan-Meier method. Univariable and multivariable Cox regression analyses were performed to evaluate independent prognostic factors.
A total of 172 patients were included in this study. Based on urine cytology group (after OCSI), RFS did not reach the median value in the Negative group. In the LGUN+AUC group, the median RFS was 615.00 days. In the SHGUC+HGUC group, the median RFS was 377.00 days. In survival analysis, the Negative group had a longer RFS than the SHGUC+HGUC group (p=0.013). However, Cox regression analysis showed that SHGUC+HGUC was not an independent prognostic factor for recurrence.
Urine cytology results after OCSI following TURBT in NMIBC were associated with bladder tumor recurrence. Specifically, SHGUC or HGUC in urine cytology after OCSI showed earlier recurrence than negative cases. However, further research is needed to accurately determine whether it is an independent prognostic factor.
探讨经尿道膀胱肿瘤切除术（TURBT）后行持续生理盐水灌洗（OCSI）后尿细胞学结果与非肌层浸润性膀胱癌（NMIBC）膀胱肿瘤复发的关系。
对 2016 年至 2020 年在我院行 TURBT 诊断为 NMIBC 的患者进行回顾性研究。所有患者在 TURBT 后均行 OCSI，并于术后第 1 天行尿细胞学检查。尿细胞学分为三组：阴性、低级别尿路上皮肿瘤（LGUN）+非典型尿路上皮细胞（AUC）和疑似高级别尿路上皮癌（SHGUC）+高级别尿路上皮癌（HGUC）。采用 Kaplan-Meier 法比较各组无复发生存率（RFS）。采用单变量和多变量 Cox 回归分析评估独立预后因素。
本研究共纳入 172 例患者。根据尿细胞学分组（OCSI 后），阴性组 RFS 未达到中位数。LGUN+AUC 组的中位 RFS 为 615.00 天，SHGUC+HGUC 组的中位 RFS 为 377.00 天。生存分析显示，阴性组 RFS 长于 SHGUC+HGUC 组（p=0.013）。然而，Cox 回归分析显示，SHGUC+HGUC 不是复发的独立预后因素。
NMIBC 行 TURBT 后 OCSI 后的尿细胞学结果与膀胱肿瘤复发相关。具体来说，OCSI 后尿细胞学中出现 SHGUC 或 HGUC 比阴性病例更早复发。然而，需要进一步研究以准确确定其是否为独立的预后因素。
