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UROLOGY：哪些上尿路肿瘤病人应用钬激光更安全？

2018-01-02 MedSci MedSci原创

UpperTractcarcinomalaserPhotoablationUreteroscopy
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近日，来自于欧洲的泌尿外科医师们在软镜下利用钬激光烧掉病人的上尿路肿瘤，并对肿瘤的大小、生长部位、分级对患者无进展生存期的影响展开了研究。

近日，来自于欧洲的泌尿外科医师们在软镜下利用钬激光烧掉病人的上尿路肿瘤，并对肿瘤的大小、生长部位、分级对患者无进展生存期的影响展开了研究。

研究人员共收集了2003年至2015年间共92例病人的数据并严格按照EAU公布的指南进行随访，随访内容包括肿瘤的分级，是否远处转移以及是否发生无法保守治疗的复发。然后研究人员利用Kaplan-Meie曲线图评估疾病的进展，指标包括肿瘤大小、转移和分级，并利用COX回归评估肿瘤的临床和病理学特征对无进展生存期的影响。

每位患者的中位随访期为52个月(时间范围 27.8月-76.4月)。经过比对，研究人员发现：1.肿瘤小于等于1cm的患者无进展期生存率为68%，而大于1cm的患者无进展生存期为72% (p = 0.9)；2.单发肿瘤病人的无进展期生存率为72%，多发肿瘤的病人无进展期生存率为69%(p = 0.6)；3.低分级肿瘤病人的无进展期生存率为75，高分级肿瘤病人的无进展期生存率为52% (p = 0.03)；4.COX回归分析结果显示肿瘤的分级为该疾病进展的唯一独立影响因素(HR 5.16， 95% CI 1.19-22.26， p = 0.03)。

结论：对于上尿路肿瘤病人来说，肿瘤的高分级独立地减少了他们的无进展生存期，而肿瘤的大小和是否多发并不会增加他们的无进展生存期。

原始出处：

Luca Villa.et al.Which Patients with Upper Tract Urothelial Carcinoma Can be Safely Treated with Flexible Ureteroscopy with Holmium：YAG Laser Photoablation？ Long-Term Results from a High Volume Institution. UROLOGY.2018

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    2018-01-07 chunjianf

    学习了.谢谢分享

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=276295, encodeId=ca852e6295d0, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRk75KAEKrLGic0S0IvH1aNynsEFQWiaNKdtzvtwj2kafCoPg2icYVbrfBCFiaS74X1uEiaaTTY1H9Xyem/0, createdBy=cec11614828, createdName=chunjianf, createdTime=Sun Jan 07 09:09:09 CST 2018, time=2018-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279699, encodeId=ea2912e969906, content=<a href='/topic/show?id=265c66e50ea' target=_blank style='color:#2F92EE;'>#激光#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66750, encryptionId=265c66e50ea, topicName=激光)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4fd6156, createdName=oliver169, createdTime=Thu Jan 04 12:35:00 CST 2018, time=2018-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=274978, encodeId=32c62e497807, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Wed Jan 03 09:00:04 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=274961, encodeId=ad252e496159, content=好好好学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM6DGOvNrRdcib3UmzMgpEQpl0ENSJScphsFtdgfibXX1g1IuEYGCjP23UqCd52TxTpSZibtPiclyusaHicnNXd78alaia19Qy1nAFo18/0, createdBy=50381491660, createdName=zwjnj2, createdTime=Wed Jan 03 07:43:41 CST 2018, time=2018-01-03, status=1, ipAttribution=)]
    2018-01-04 oliver169

    #激光#

    0

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    2018-01-03 飛歌

    学习了很有用

    0

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    2018-01-03 zwjnj2

    好好好学习学习

    0

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