女性膀胱白斑病经尿道电切术后复发的相关危险因素分析

Analysis of the risk factors of recurrence after transurethral resection of female vesical leukoplakia

摘要:

目的 探讨女性膀胱白斑病经尿道电切术（TUR）后复发的相关危险因素。方法 回顾性分析2010年1月－2018年11月株洲恺德心血管病医院和中南大学湘雅医院257例膀胱白斑病行TUR患者的临床资料，并对223例患者进行随访。对影响女性膀胱白斑病TUR术后复发的相关危险因素进行单因素和多因素COX分析。结果 中位随访时间为49个月（12～121个月）。5年无复发率为86.1%，1年无复发率为91.9%。单因素Cox回归分析显示，尿路感染［危险比（HR）= 2.111，95%置信区间（CI）：1.043～4.271，P = 0.038］和膀胱非典型尿路上皮增生（HR = 4.191，95%CI：2.006～8.756，P = 0.000）是膀胱白斑病TUR术后复发的危险因素。多因素Cox回归分析提示，膀胱非典型尿路上皮增生（HR = 3.506，95%CI：1.663～7.392，P = 0.001）是女性膀胱白斑病TUR术后复发的独立危险因素。结论 膀胱非典型尿路上皮增生是女性膀胱白斑病TUR术后复发的独立危险因素，针对上述因素加强术后随访可降低术后复发的风险。

Abstract:

Objective To investigate the risk factors for recurrence of female vesical leukoplakia after transurethral resection (TUR).Methods Clinical data of 257 patients who underwent transurethral resection of vesical leukoplakia from January 2010 to November 2018 were retrospective collected. 223 patients were followed up. Univariate and multivariate Cox analysis were performed on the risk factors for recurrence of female vesical leukoplakia after TUR.Results The median follow-up time is 49 months (Time range: 12 months to 121 months). Five-year recurrence-free rate and 1-year recurrence-free rate were 86.1% and 91.9%, respectively. Univariate Cox analysis revealed urinary tract infection [hazard ratio (HR) = 2.111, 95% confidence interval (CI): 1.043～4.271, P = 0.038] and atypical urothelial hyperplasia of the bladder (HR = 4.191, 95%CI: 2.006～8.756, P = 0.000) were significant risk factor for recurrence. Multivariate Cox analysis suggested atypical urothelial hyperplasia of the bladder (HR = 3.506; 95%CI: 1.663～7.392, P = 0.001) was an independent risk factor for recurrence of female vesical leukoplakia after transurethral resection.Conclusion Atypical urothelial hyperplasia of the bladder is an independent risk factor for postoperative recurrence of female vesical leukoplakia. Enhanced postoperative follow-up for these factors can reduce the risk of postoperative recurrence.