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抗血栓药物的使用能否成为膀胱癌早期诊断的预测因素?:一项单中心分析。

Can the use of antithrombotic drugs be a predictive factor in the early diagnosis of bladder cancer?: A single-center analysis.

机构信息

Faculty of Medicine, Department of Urology, Hitit University, Çorum, Turkey.

Faculty of Medicine, Department of Biostatistics, Hitit University, Çorum, Turkey.

出版信息

Medicine (Baltimore). 2024 May 17;103(20):e38228. doi: 10.1097/MD.0000000000038228.

Abstract

Hematuria is the most common symptom of bladder cancer (BCa). It is well-known that the frequency of hematuria increases with the use of antithrombotic drugs (ATDs). We designed our study with the hypothesis that patients using antithrombotic drugs who present with the complaint of hematuria and are subsequently diagnosed with BCa may receive an earlier diagnosis, leading to lower tumor grades and stages. Data of 441 consecutive patients who presented to our urology outpatient clinic with macroscopic hematuria between 2020 and 2023 were retrospectively evaluated. A total of 88 patients (21.4%) with a primary diagnosis of BCa were included in our study. Patients were divided into 2 groups: those using ATDs during the episode of macroscopic hematuria (group 1) and those not using ATDs (group 2). Univariate and multivariate binary logistic regression analysis was performed to identify risk factors that could predict tumor grade. The incidence of multiple tumors (>1) was significantly lower in patients using ATDs (P = .033). The number of patients with tumor size larger than 3 cm was significantly higher in the group not using ATDs (P = .005). The rates of pathological T1 stage in the group using ATDs were significantly lower than those in the nonuser group (P = .038). According to the results of the multivariate model, the effect of pathology stage and ATD use on predicting tumor grade was significant (P = .002 and P < .001, respectively). The probability of having a high-grade tumor in patients with pathology stage T1 was 5.32 times higher than in patients with pathology stage TA. The probability of having a high-grade tumor in patients not using ATDs was 7.73 times higher than in those using ATDs. The effect of pathology stage and ATD use on predicting tumor grade was found to be significant. The probability of having a high-grade tumor was higher in patients not using ATDs compared to those using ATDs. In light of these results, we can state that the use of ATDs is a positive predictive factor in the early diagnosis of BCa, bringing along the chance of early diagnosis and treatment.

摘要

血尿是膀胱癌(BCa)最常见的症状。众所周知,血尿的频率随着抗血栓药物(ATD)的使用而增加。我们设计本研究的假设是,使用抗血栓药物出现血尿症状并随后被诊断为 BCa 的患者可能会更早得到诊断,从而导致肿瘤分级和分期较低。回顾性评估了 2020 年至 2023 年间因肉眼血尿就诊于我院泌尿科门诊的 441 例连续患者的数据。本研究共纳入 88 例(21.4%)原发性膀胱癌患者。患者分为 2 组:血尿发作时使用 ATD 组(第 1 组)和未使用 ATD 组(第 2 组)。采用单变量和多变量二元逻辑回归分析来确定可预测肿瘤分级的危险因素。使用 ATD 的患者多发肿瘤(>1 个)的发生率明显较低(P =.033)。未使用 ATD 的患者肿瘤大小大于 3 cm 的比例明显较高(P =.005)。使用 ATD 的患者病理 T1 期的比例明显低于未使用者(P =.038)。多变量模型的结果显示,病理分期和 ATD 使用对预测肿瘤分级的影响具有统计学意义(P =.002 和 P <.001)。病理分期为 T1 的患者患高级别肿瘤的概率是 TA 期患者的 5.32 倍。未使用 ATD 的患者患高级别肿瘤的概率是使用 ATD 的患者的 7.73 倍。病理分期和 ATD 使用对预测肿瘤分级的影响具有统计学意义。未使用 ATD 的患者患高级别肿瘤的概率高于使用 ATD 的患者。鉴于这些结果,我们可以说使用 ATD 是 BCa 早期诊断的一个积极预测因素,带来了早期诊断和治疗的机会。

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