高尿酸血症与女性膀胱癌相关性的临床研究

发布时间：2018-02-01 04:34

  本文关键词： 氋尿酸血症 膀胱癌 复发　出处：《大连医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:膀胱癌是泌尿外科常见恶性肿瘤,约有90%为尿路上皮癌,其中浅表性膀胱癌约占75%～85%。膀胱的侧壁和三角区是膀胱肿瘤高发部位,肿瘤可以单个或多个形式存在。膀胱癌有三个重要的生物学特性:局部浸润、远处转移、反复复发。目前,在膀胱癌发病原因上已有较为深入的研究。临床上普遍认为职业接触和吸烟是与膀胱癌相关的最主要的环境因素。但关于膀胱癌复发机制目前尚无统一观点,相关的研究尚处于探索阶段,临床上大多从病理特征上进行统计分析,如肿瘤数目、大小、分期分级等,但对膀胱癌复发的生物学相关机制尚未完全探明。已有研究发现高尿酸血症患者泌尿系统肿瘤的发病率及死亡率均有增加。在我国,泌尿系统肿瘤伴高尿酸血症的患者并非少见,但对两者之间相关性的研究鲜有报道。我们对112例女性膀胱癌患者的分析以及同期与96例排除肿瘤、泌尿系统疾病、急慢性炎症、严重肝肾功能不全、激素替代疗法女性患者进行回顾性分析,探讨高尿酸血症与女性膀胱癌之间的相关性,旨在为临床诊断及流行病学调查提供某些有价值的线索。方法:收集我院2014年1月至2016年12月112例女性膀胱癌患者的临床资料,其中高尿酸血症者22例,非高尿酸血症者90例。以同期非肿瘤、非泌尿系统、非急慢性炎症、严重肝肾功能不全、激素替代疗法患者96例为对照组,比较2组患者高尿酸血症的发生率及尿酸值之间的差异;分析112例女性膀胱癌患者中伴高尿酸血症者与不伴高尿酸血症者膀胱肿瘤的级别、浸润、个数及复发情况。结果:女性膀胱癌患者和对照组患者高尿酸血症发生率分别为19.6%和17.7%,两组差异无统计学意义(χ2=0.127,P0.05,OR=0.88);但女性膀胱癌患者的血尿酸水平均值高于对照组女性,差异有统计学意义(t=2.226,P0.05,95%CI:0.437～1.775)。女性膀胱癌患者中高尿酸血症者与尿酸正常者相比,复发的风险增加,有显著统计学差异(χ2=19.497,P0.01)。而与肿瘤的级别、浸润、个数比较差异无统计学意义(P0.05)。结论:本研究发现女性膀胱癌患者的血尿酸水平高于对照组女性,提示肿瘤细胞可能通过某种方式增加人体内尿酸的产生,形成利于肿瘤细胞增殖的内环境,这也可能是引起或加速膀胱癌发生发展的原因之一。高尿酸血症与女性膀胱癌的复发关系密切,可能是女性膀胱癌的复发的危险因素之一,造成二者的相关性的原因还需要更进一步分析。伴高尿酸血症的中老年女性膀胱癌患者,应密切随诊复查以免延误病情。
[Abstract]:Objective: bladder cancer is a common malignant tumor in urology, and there are about 90% cases of urothelial carcinoma, among which superficial bladder carcinoma accounts for 75% 85%. The lateral wall and triangle area of bladder are the high incidence sites of bladder tumor. Tumors can exist in single or multiple forms. Bladder cancer has three important biological characteristics: local infiltration, distant metastasis, and recurrent recurrence. Occupational exposure and smoking are generally considered as the most important environmental factors related to bladder cancer. However, there is no unified view on the recurrence mechanism of bladder cancer. The related research is still in the exploratory stage, most of the clinical from the pathological characteristics of statistical analysis, such as the number of tumors, size, staging, and so on. However, the biological mechanism of bladder cancer recurrence has not been fully elucidated. It has been found that the incidence and mortality of urinary system tumors in patients with hyperuricemia have increased. Patients with urologic neoplasms associated with hyperuricemia are not uncommon, but there are few reports of the correlation between the two. We analyzed 112 women with bladder cancer and 96 patients excluded the tumor at the same time. Urinary system diseases, acute and chronic inflammation, severe liver and kidney insufficiency, hormone replacement therapy in female patients were retrospectively analyzed to explore the relationship between hyperuricemia and female bladder cancer. To provide some valuable clues for clinical diagnosis and epidemiological investigation. Methods: the clinical data of 112 female patients with bladder cancer from January 2014 to December 2016 in our hospital were collected. There were 22 cases of hyperuricemia and 90 cases of non-hyperuricemia. 96 cases of hormone replacement therapy were used as control group. The incidence of hyperuricemia and the difference of uric acid between the two groups were compared. The grade and infiltration of bladder tumors in 112 women with or without hyperuricemia were analyzed. Results: the incidence of hyperuricemia in female bladder cancer patients and control group was 19.6% and 17.7, respectively. There was no significant difference between the two groups (蠂 2 / 0.127). P0.05 ORA 0.88; However, the mean value of serum uric acid water in female patients with bladder cancer was higher than that in the control group, the difference was statistically significant (P0.05). 95 CI: 0.437 / 1.775.The risk of recurrence in female bladder cancer patients with hyperuricemia was significantly higher than that with normal uric acid (蠂 2, 19.497). There was no significant difference in the grade, invasion and number of tumor. Conclusion: the level of serum uric acid in women with bladder cancer is higher than that in women in control group. These results suggest that tumor cells may increase the production of uric acid in human body in some way and form an internal environment conducive to the proliferation of tumor cells. Hyperuricemia is closely related to the recurrence of bladder cancer in women and may be one of the risk factors for recurrence of bladder cancer in women. The causes of the correlation need to be further analyzed. The elderly women with hyperuricemia should follow up closely to avoid delay.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.14;R589.7
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本文编号：1480930