膀胱癌合并糖尿病患者的临床病理特点分析

Analysis of clinicopathological characteristics of bladder cancer patients with diabetes mellitus

摘要:

目的： 分析膀胱癌合并糖尿病患者的临床病理特点，为膀胱癌的临床诊疗提供一定参考。方法： 回顾性收集2014年1月至2019年2月于空军军医大学第一附属医院泌尿外科手术治疗的原发性尿路上皮膀胱癌的患者资料，将合并糖尿病的患者列为糖尿病组（DM组），未合并糖尿病的患者列为非糖尿病组（No-DM组），对患者的临床和病理特征展开分析。结果： DM组患者的年龄和高血压比例高于No-DM组，差异有统计学意义（P<0.05），2组患者性别、教育程度、吸烟、饮酒、体质指数、主诉症状、病程长短、泌尿系感染和前列腺增生等临床特征的构成比差异无统计学意义（P>0.05）。2组患者肿瘤分级的构成比差异有统计学意义（P=0.007），DM组高级别癌所占比例（52.8%）高于No-DM组（34.2%）；2组肿瘤分期、肿瘤数量和肿瘤大小的构成比差异无统计学意义（P>0.05）。多因素logistic回归分析显示，年龄（P<0.05）、病程（P=0.045）和糖尿病（P=0.026）是膀胱癌恶性程度分级的独立影响因素，而性别、吸烟、饮酒、高血压和体质指数对膀胱癌恶性程度分级的影响无统计学意义（P>0.05）。结论： 年龄、病程、糖尿病是膀胱癌病理分级的独立影响因素，临床上关注膀胱癌合并糖尿病患者的诊疗特点，对改善其预后有一定的积极意义。

Abstract:

Objective: To analyze the clinicopathological characteristics of bladder cancer with diabetes mellitus, and to provide reference for the clinical diagnosis and treatment of bladder cancer. Methods: The data of patients with primary urothelial bladder cancer treated in urology department of Xijing Hospital from January 2014 to February 2019 were collected retrospectively. Patients with diabetes mellitus were classified as diabetic group (DM group) and patients without diabetes mellitus were classified as non-diabetic group (No-DM group). The clinical and pathological characteristics of the patients were analyzed. Results: The age and the proportion of hypertension in DM group were higher than that in No-DM group, with statistical significance (P<0.05). There was no significant difference between the two groups in the constituent ratio of clinical characteristics such as gender, education level, smoking, drinking, body mass index (BMI), complaint symptoms, course of disease, urinary tract infection and hyperplasia of prostate (P>0.05). There was significant difference in the constituent ratio of tumor grade between the two groups (P=0.007), and the proportion of high grade carcinoma in DM group (52.8%) was higher than that in No-DM group (34.2%). There was no significant difference in tumor stage, tumor number and tumor size between the two groups (P>0.05). Multivariate logistic regression analysis showed that age (P<0.05), course of disease (P=0.045) and diabetes mellitus (P=0.026) were independent influencing factors of cancer grade, while gender, smoking, drinking, hypertension and BMI had no statistical significance in malignant grade of bladder cancer (P>0.05). Conclusion: Age, course of disease and diabetes mellitus were independent factors influencing the pathological grade of bladder cancer. We should pay attention to the diagnosis and treatment characteristics of bladder cancer patients with diabetes mellitus, which has a certain positive significance for improving its prognosis.