【摘要】 目的评估血清载脂蛋白A1(Apo A-1)水平在输尿管癌术后预后预测意义。方法回顾性分析了2000年至2012年在中山大学附属肿瘤医院泌尿外科行根治性手术治疗的99例(98例行输尿管癌根治术,1例行输尿管癌根治+膀胱全切术)输尿管癌患者的临床资料,以生存为主要观察重点,通过ROC曲线分析确定最佳诊断阈值;卡方检验、单因素、多因素分析,探索血清载脂蛋白A1水平与输尿管癌术后肿瘤特异性生存率的关系。结果术前Apo A-1(Apo A-1>1.06 g/L)高表达组具有更长的肿瘤特异性生存时间(P=0.037)。单因素分析显示:p T3-4分期,淋巴结转移,肿瘤分级以及术前血清Apo A-1水平与术后肿瘤特异性生存时间相关。进一步多因素分析显示:肿瘤分期、Apo A-1水平是输尿管癌术后预后的独立危险因素。结论术前载脂蛋白A1水平是输尿管癌术后预后的独立危险因素。更多还原

【Abstract】 Objective To evaluate the prognostic value of serum apolipoprotein A-1(Apo A-1) level in patients with upper tract urothelial carcinoma(UTUC) after the performance of rapid surgery. Methods This study was a retrospective study of 99 patients who were diagnosed with UTUC and underwent nephroureterectomy(98 cases) and radical cystectomy(1 case). Serum lipids and apolipoprotein values were retrieved. Receiver operation characteristic curve analysis(ROC curve), Chi-square tests and univariate and multivariate Cox proportional hazards analysis were performed to evaluate the association between Apo A-1and cancer specific survival. Results Higher baseline level of Apo A-1 was significantly with superior CSS(P=0.037). Statistical analysis of qualitative variables corresponding to patient clinicopathological features revealed that CSS was significantly associated with the following parameters on univariate analysis: p T3-4stage, lymphoid nodal status, tumour grade, and Apo A-1 level. Multivariate analysis revealed that a high Apo A-1 level is an independent protective factor in UTUC compared with a low Apo A-1 level(P=0.048).Conclusions The current study suggests that serum Apo A-1(>1.06 g/L) was considered as an optimal cut-off for tailoring the prognosis of UTUC. Serum Apo A-1 is an independent protective factor in UTUC.However, external worldwide investigations are needed to further explore the prognosis role of Apo A-1 in UTUC.更多还原