目的 探讨淋巴血管侵犯(LVI)对行根治性膀胱切除术(RC)的非转移性膀胱癌病人预后的影响.方法 回顾性分析79例行RC的非转移性膀胱癌病人的临床病理资料,分析LVI与各临床病理因素的关系,应用Kaplan-Meier法和多因素Cox等比例风险模型分析LVI对总生存期(OS)的影响.结果 79例病人中位随访时间56.9个月,LVI阳性19例(24％).23例病人死亡,包括10例LVI阳性病人及13例LVI阴性病人.LVI与年龄、性别、体质量指数、吸烟史、高血压史、糖尿病史、组织学分级、ECOG评分、是否合并原位癌、T分期无关(P>0.05).LVI阳性病人的OS低于LV阴性病人(χ2=8.805,P<0.05).多因素分析显示,年龄、T分期、LVI是影响OS的独立危险因素(HR=0.349～11.901,P<0.05).结论 LVI是影响行RC的非转移性膀胱癌病人OS的独立危险因素.

目的:研究IL-6水平对根治性膀胱切除术(RC)患者预后的影响.方法:收集124例2011～2012年在青岛大学附属医院行RC患者的临床及病理资料,应用酶联免疫吸附试验测定其术前血清IL-6水平,按照IL-6水平中位数分为IL-6低水平组与IL-6高水平组,比较两组间临床病理特征的差异,并采用Kaplan-Meier生存分析、Cox比例风险回归模型分析血清11-6水平对患者预后的影响.结果:两组患者T分期比较差异有统计学意义(P＜0.05),年龄、性别、BMI、是否合并原位癌、吸烟、高血压病、糖尿病、ECOG评分、辅助治疗等方面比较差异均无统计学意义.Kaplan-Meier生存分析中,IL-6高水平组总生存时间明显低于IL-6低水平组(P＜0.05).Cox比例风险回归模型分析表明T、M分期为患者预后的独立影响因素(P＜0.05).结论:RC患者术前血清IL-6高水平提示预后较差,可作为判断预后和术后辅助治疗的依据.

Objective To investigate the clinical effect of retroperitoneal laparoscopic partial nephrectomy with selective renal artery branch clamping in the treatment of renal tumor patients with a RENAL score of ≥7.Methods A total of 63 renal tumor patients with a RENAL score of ≥7 who were hospitalized in The Affiliated Hospital of Qingdao University and Jiaozhou Central Hospital from June 2013 to December 2015 were enrolled and treated with selective renal artery branch clamping or standard partial nephrectomy.The two groups were compared in terms of time of operation,warm ischemia time,rate of positive resection margin,blood transfusion rate,intraoperative blood loss,postoperative complications,and length of hospital stay,as well as renal function at different time points.Results The standard partial nephrectomy group had a significantly shorter time of operation than the selective renal artery branch clamping group (t =4.859,P＜0.05).There were no significant differences between the two groups in warm ischemia time,rate of positive resection margin,blood transfusion rate,intraoperative blood loss,incidence rates of postoperative complications,and length of hospital stay (P＞0.05).At one month after surgery,the selective renal artery branch clamping group had a significantly greater reduction in estimated glomerular filtration rate (eGFR) compared with the standard partial nephrectomy group (t =2.687,P ＜0.05);at 12 months after surgery,there was no significant difference in eGFR between the two groups (P＞0.05).Conclusion In renal tumor patients with a RENAL score of ≥7,retroperitoneal laparoscopic partial nephrectomy with selective renal artery branch clamping can protect their renal function in the early stage after surgery and does not increase intraoperative blood loss and postoperative complications.It is a safe and effective surgical method and thus holds promise for clinical application.

Objective: To explore the association of prostate volume and tumor grade in patients of prostate cancer in Chinese.Methods: Clinical data of 70 patients who were diagnosed with prostate cancer and underwent radical prostatectomy between Jan 2005 and Oct 2011 were collected.The correlation of prostate volume with tumor grade were analyzed with SPSS 13.0 statistical software.Results: The pathological grade of tumor in biopsy specimens was statistically different with the final pathological grade in radical prostectomy specimens(P<0.05).Prostate volume had an inverse relationship with high grade tumor in both biopsy and radical prostectomy specimens.Small prostate volume was associated with high grade prostate cancer as well as positive surgical margin and extraprostatic extension but not with seminal vesicle invasion and lymph node involvement on univariate analysis.On multivariate analysis adjusted for age,body mass index(BMI) and prostate specific antigen(PSA) prostate volume had an strong correlationship with high grade tumor(OR 0.32;95% CI 0.18,0.56 per 1 milliliter,P<0.05),positive surgical margin(OR 0.35;95% CI 0.21,0.53 per 1 milliliter,P<0.05),extraprostatic extension(OR 0.28;95% CI 0.14,0.57 per 1 milliliter,P<0.05) and seminal vesicle invasion(OR 0.37;95% CI 0.17,0.81 per 1 milliliter,P<0.05).Conclusion: Prostate volume is an important predictor of high grade prostate cancer.The ability to predict high grade disease is in favor of selecting the best therapeutic regime and improving the efficacy of treatment.

目的 探讨肾脏神经鞘瘤的临床特点.方法 回顾性分析2011年3月我院泌尿外科诊治的1例肾脏神经鞘瘤患者的临床资料,结合国内外有关文献报道分析肾脏神经鞘瘤的诊断和治疗特点.结果 该患者充分术前准备后行手术完整切除肿瘤,术后病理证实均为良性神经鞘瘤,随访未发现复发.结论 肾脏神经鞘瘤罕见,诊断困难,影像学检查无特异性,确诊依靠病理检查,理想的治疗方法是通过外科手术完整切除肿瘤,其预后良好,早期复发率低.