吸烟及累积吸烟暴露量影响非肌层浸润性膀胱癌患者的预后研究

发布时间：2018-05-12 15:38

  本文选题：吸烟状况 + 累积吸烟暴露量　； 参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:分析吸烟状况及累积吸烟暴露量对非肌层浸润性膀胱癌患者预后影响。方法:收集484例在我院行经尿道膀胱肿瘤电切术的非肌层浸润性膀胱癌患者的临床病理资料及吸烟状况。通过Kaplan-Meier法绘制生存曲线评估吸烟或吸烟累积暴露量对肿瘤复发的影响,应用Cox风险回归模型对变量进行多因素分析,计算得出影响非肌层浸润性膀胱癌预后复发的危险因素。结果:484例患者的平均随访时间为34.1个月,在多因素分析中我们发现肿瘤的病理分级、既往复发病史、肿瘤数目、肿瘤大小均能显著性的影响肿瘤复发,吸烟状况并不显著性的影响肿瘤复发(p=0.066)。而在既往吸烟及当前吸烟的患者中进行多因素分析,我们发现肿瘤病理分级、既往复发病史、肿瘤数目、肿瘤大小、累积吸烟暴露量以及戒烟状况均能显著性的影响肿瘤复发,且戒烟≥10年的患者在肿瘤复发的危险是当前吸烟患者0.500倍(p=0.015)。结论:吸烟状况对非肌层浸润性膀胱癌患者肿瘤复发的影响仍存在争议,而在既往吸烟及当前吸烟的患者中,我们发现高累积吸烟暴露量可增加非肌层浸润性膀胱癌患者的肿瘤复发风险。而患者确诊膀胱癌后,长时间的戒烟(≥10年)可以降低肿瘤复发的风险。
[Abstract]:Objective: to analyze the effect of smoking status and cumulative smoking exposure on prognosis of non-myometrial invasive bladder cancer. Methods: the clinicopathological data and smoking status of 484 patients with non-muscular invasive bladder cancer undergoing transurethral resection of bladder tumor were collected. The influence of smoking or cumulative exposure to smoking on tumor recurrence was assessed by Kaplan-Meier method. The risk factors affecting the prognosis and recurrence of non-myometrial invasive bladder cancer were calculated by using Cox risk regression model and multivariate analysis. Results the mean follow-up time was 34.1 months. In the multivariate analysis, we found that the pathological grade, the history of recurrence, the number of tumor and the size of tumor could significantly affect the recurrence of tumor. Smoking status was not significantly related to tumor recurrence (P 0.066). By multivariate analysis, we found that tumor pathological grade, recurrence history, tumor number, tumor size, cumulative exposure to smoking and smoking cessation status significantly affected tumor recurrence. Patients who quit smoking for more than 10 years were 0.500 times more likely to relapse than the current smokers. Conclusion: the effect of smoking status on tumor recurrence in non-myometrial invasive bladder cancer patients is still controversial. We found that high cumulative smoking exposure increased the risk of tumor recurrence in non-myometrial invasive bladder cancer patients. After the diagnosis of bladder cancer, long-term smoking cessation (鈮，

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