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目的:探讨淋巴血管侵犯在输尿管癌患者行根治性肾输尿管切除术后出现的临床病理意义。方法:收集我院2006年1月~2012年12月行根治性肾输尿管切除术的输尿管癌患者,且术后病理结果为尿路上皮癌伴有LVI阳性的患者29例,根据患者性别、年龄、病理分期、病理分级和病理类型按照1∶2原则匹配58例LVI阴性的输尿管癌患者为阴性对照组。应用SPSS 20.0统计软件进行数据录入及处理,采用Kaplan-Meier法分别计算两组患者的总生存期及肿瘤无复发生存期,采用Log-rank检验差异有无统计学意义。结果:LVI阳性组患者平均随访36.76个月,随访期间死亡11例,1、3、5年生存率分别为93.0%、68.2%、49.2%;LVI阴性组患者平均随访41.60个月,随访期间死亡7例,1、3、5年生存率分别为98.2%、91.9%、81.8%。两组患者术后总生存率差异有统计学意义(χ~2=8.695,P=0.003);LVI阳性组患者术后出现肿瘤复发17例(58.62%),LVI阴性组患者术后出现肿瘤复发12例(20.69%),两组患者术后无复发生存率差异有统计学意义(χ~2=14.452,P<0.01)。结论:输尿管癌患者行根治性肾输尿管切除术后标本中LVI阳性是能够预测疾病的不良预后,其对于输尿管癌预后的判断及治疗有重要临床意义。
Objective: To investigate the clinicopathological significance of lymphatic invasion after radical nephroureterectomy in patients with ureteral carcinoma. Methods: Totally 29 patients with ureteral carcinoma undergoing radical nephroureterectomy from January 2006 to December 2012 in our hospital were enrolled, and 29 patients with positive urofacial epithelial carcinoma (LVI) postoperative pathology were collected. According to the sex, age , Pathological staging, pathological grade and pathological type in accordance with the 1: 2 principle matching 58 cases of LVI-negative ureteral cancer patients as a negative control group. SPSS 20.0 statistical software was used for data entry and processing. The Kaplan-Meier method was used to calculate the overall survival and recurrence-free survival of patients in both groups. Log-rank test was used to test whether the difference was statistically significant. Results: The average LVI-positive patients were followed up for 36.76 months and 11 died during follow-up. The 1,3,5-year and 1,3-year survival rates were 93.0%, 68.2% and 49.2% respectively. Patients in LVI negative group were followed up for an average of 41.60 months and died during follow-up In 7 cases, the survival rates at 1, 3 and 5 years were 98.2%, 91.9% and 81.8% respectively. There was significant difference between the two groups in overall survival (χ ~ 2 = 8.695, P = 0.003). Tumor recurrence occurred in 17 patients (58.62%) after operation in LVI positive group, and tumor recurrence occurred in LVI negative group 12 cases (20.69%) had no difference in the recurrence-free survival rate between the two groups (χ ~ 2 = 14.452, P <0.01). Conclusion: Positive LVI in specimens of patients with ureteral carcinoma after radical nephroureterectomy is a prognostic factor for the prognosis of ureteral carcinoma, which has important clinical significance.