非白种人种族/族裔在诊断上尿路尿路上皮癌时易出现不良分期和分级。
Non-Caucasian Race/Ethnicity Predisposes to Unfavorable Stage and Grade at Upper Tract Urothelial Carcinoma Diagnosis.
作者信息
Di Bello Francesco, de Angelis Mario, Siech Carolin, Peñaranda Natali Rodriguez, Tian Zhe, Goyal Jordan A, Ruvolo Claudia Collà, Califano Gianluigi, Creta Massimiliano, Saad Fred, Shariat Shahrokh F, Briganti Alberto, Chun Felix K H, Micali Salvatore, Longo Nicola, Karakiewicz Pierre I
机构信息
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada.
Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Via Pansini, 80131, Naples, Italy.
出版信息
J Racial Ethn Health Disparities. 2025 Jan 9. doi: 10.1007/s40615-025-02285-0.
OBJECTIVE
To test whether race/ethnicity affects stage or grade distribution at upper tract urothelial carcinoma (UTUC) diagnosis.
METHODS
Within the Surveillance, Epidemiology, and End Results (SEER) database 2004-2020, UTUC patients were identified. Multivariable logistic regression models tested for the association between race/ethnicity and stage as well as grade at diagnosis according to renal pelvis vs. ureteral origin. Stage at presentation was defined as (i) metastatic stage (TNM) and (ii) advanced stage (locoregional or metastatic (TNM)).
RESULTS
Of 14,384 UTUC patients, 8926 (62%) were renal pelvis. Of renal pelvis UTUC patients, 7064 (79%) were Caucasian, 797 (9%) Hispanic, 623 (7%) Asian Pacific Islander (API), and 442 (5%) African American (AA). Relative to Caucasians, API (odd ratio (OR) 1.85, 95% confidence interval (CI) 1.44-2.37, p < 0.001) and AA (OR 1.37, 95% CI 1.02-1.83, p = 0.03) patients more frequently harbored metastatic stage. APIs also more frequently harbored advanced (OR 1.33, 95% CI 1.11-1.60, p = 0.002) stage and high (OR 1.33, 95% CI 1.07-1.67, p = 0.01) grade. Of 5458 (38%) ureteral UTUC patients, 4360 (80%) were Caucasian, 362 (7%) Hispanic, 509 (9%) API, and 227 (4%) AA. Relative to Caucasians, Hispanic (OR 1.45, 95% CI 1.01-2.05, p = 0.03) patients more frequently harbored metastatic stage. APIs also more frequently harbored advanced stage (OR 1.22, 95% CI 1.02-1.47, p = 0.03) and high (OR 1.94, 95% CI 1.49-2.55, p < 0.001) grade.
CONCLUSIONS
Race/ethnicity other than Caucasian, such as API and Hispanic, may predispose to higher odds of metastatic (TNM) or advanced (TNM) stages as well as to higher grade at initial diagnosis.
目的
检验种族/民族是否会影响上尿路尿路上皮癌（UTUC）诊断时的分期或分级分布。
方法
在2004 - 2020年监测、流行病学和最终结果（SEER）数据库中识别UTUC患者。多变量逻辑回归模型根据肾盂与输尿管起源，检验种族/民族与诊断时分期以及分级之间的关联。就诊时的分期定义为：（i）转移期（TNM）和（ii）晚期（局部区域或转移期（TNM））。
结果
在14384例UTUC患者中，8926例（62%）为肾盂癌。在肾盂UTUC患者中，7064例（79%）为白种人，797例（9%）为西班牙裔，623例（7%）为亚太岛民（API），442例（5%）为非裔美国人（AA）。与白种人相比，API患者（优势比（OR）1.85，95%置信区间（CI）1.44 - 2.37，p < 0.001）和AA患者（OR 1.37，95% CI 1.02 - 1.83，p = 0.03）更常处于转移期。API患者也更常处于晚期（OR 1.33，95% CI 1.11 - 1.60，p = 0.002）和高分级（OR 1.33，95% CI 1.07 - 1.67，p = 0.01）。在5458例（38%）输尿管UTUC患者中，4360例（80%）为白种人，362例（7%）为西班牙裔，509例（9%）为API，227例（4%）为AA。与白种人相比，西班牙裔患者（OR 1.45，95% CI 1.01 - 2.05，p = 0.03）更常处于转移期。API患者也更常处于晚期（OR 1.22，95% CI 1.02 - 1.47，p = 0.03）和高分级（OR 1.94，95% CI 1.49 - 2.55，p < 0.001）。
结论
除白种人外的其他种族/民族，如API和西班牙裔，在初始诊断时可能更容易出现转移期（TNM）或晚期（TNM）以及更高分级。
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