【摘要】 目的:探讨膀胱腺癌的临床病理特征及预后影响因素。方法:回顾性分析2011年8月至2018年1月收治的57例膀胱腺癌患者的临床资料，采用Kaplan-Meier法绘制生存曲线，通过单因素及多因素Cox回归分析筛选预后独立危险因素。结果:57例患者中，非脐尿管腺癌占68.4%(39/57),脐尿管腺癌占31.6%(18/57)。患者1年、3年及5年生存率分别为93.9%、53.6%和50.2%。单因素分析显示，性别、年龄、术中输血、术后复发、淋巴结转移、远处转移、合并肾积水、病理分级和职业对生存率有显著影响(均P<0.05);多因素分析表明，性别(RR=6.74,P=0.003)、年龄>65岁(RR=7.47,P=0.004)、远处转移(RR=41.35,P=0.001)和合并肾积水(RR=8.17,P=0.006)是独立预后因素。结论:膀胱腺癌恶性程度高，男性、高龄(>65岁)、远处转移及合并肾积水是其预后的独立危险因素。早期手术干预和个体化治疗可能改善生存。更多还原

【Abstract】 Objective:To investigate the clinicopathological features and prognostic factors of bladder adenocarcinoma.Methods:Clinical data of 57 patients with pathologically confirmed bladder adenocarcinoma treated between August 2011 and January 2018 were retrospectively analyzed.Survival curves were plotted using the Kaplan-Meier method.Univariate and multivariate Cox regression analyses were employed to identify independent prognostic risk factors.Results:Among the 57 patients, non-urachal adenocarcinoma accounted for 68.4%(39/57),and urachal adenocarcinoma for 31.6%(18/57).The 1-year, 3-year, and 5-year survival rates were 93.9%,53.6%,and 50.2%,respectively.Univariate analysis revealed that gender, age, intraoperative blood transfusion, recurrence, lymph node metastasis, distant metastasis, hydronephrosis, pathological grade, and occupation significantly affected survival rates(all P<0.05).Multivariate analysis indicated that gender(RR=6.74,P=0.003),age >65 years old(RR=7.47,P=0.004),distant metastasis(RR=41.35,P=0.001),and hydronephrosis(RR=8.17,P=0.006) were independent prognostic risk factors.Conclusion:Bladder adenocarcinoma is highly malignant.Male, advanced age(>65 years old),distant metastasis, and hydronephrosis are independent risk factors for poor prognosis.Early surgical intervention and personalized treatment may improve survival.更多还原