本文關鍵詞： 氋尿酸血癥 膀胱癌 復發(fā)　出處：《大連醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:膀胱癌是泌尿外科常見惡性腫瘤,約有90%為尿路上皮癌,其中淺表性膀胱癌約占75%～85%。膀胱的側壁和三角區(qū)是膀胱腫瘤高發(fā)部位,腫瘤可以單個或多個形式存在。膀胱癌有三個重要的生物學特性:局部浸潤、遠處轉移、反復復發(fā)。目前,在膀胱癌發(fā)病原因上已有較為深入的研究。臨床上普遍認為職業(yè)接觸和吸煙是與膀胱癌相關的最主要的環(huán)境因素。但關于膀胱癌復發(fā)機制目前尚無統一觀點,相關的研究尚處于探索階段,臨床上大多從病理特征上進行統計分析,如腫瘤數目、大小、分期分級等,但對膀胱癌復發(fā)的生物學相關機制尚未完全探明。已有研究發(fā)現高尿酸血癥患者泌尿系統腫瘤的發(fā)病率及死亡率均有增加。在我國,泌尿系統腫瘤伴高尿酸血癥的患者并非少見,但對兩者之間相關性的研究鮮有報道。我們對112例女性膀胱癌患者的分析以及同期與96例排除腫瘤、泌尿系統疾病、急慢性炎癥、嚴重肝腎功能不全、激素替代療法女性患者進行回顧性分析,探討高尿酸血癥與女性膀胱癌之間的相關性,旨在為臨床診斷及流行病學調查提供某些有價值的線索。方法:收集我院2014年1月至2016年12月112例女性膀胱癌患者的臨床資料,其中高尿酸血癥者22例,非高尿酸血癥者90例。以同期非腫瘤、非泌尿系統、非急慢性炎癥、嚴重肝腎功能不全、激素替代療法患者96例為對照組,比較2組患者高尿酸血癥的發(fā)生率及尿酸值之間的差異;分析112例女性膀胱癌患者中伴高尿酸血癥者與不伴高尿酸血癥者膀胱腫瘤的級別、浸潤、個數及復發(fā)情況。結果:女性膀胱癌患者和對照組患者高尿酸血癥發(fā)生率分別為19.6%和17.7%,兩組差異無統計學意義(χ2=0.127,P0.05,OR=0.88);但女性膀胱癌患者的血尿酸水平均值高于對照組女性,差異有統計學意義(t=2.226,P0.05,95%CI:0.437～1.775)。女性膀胱癌患者中高尿酸血癥者與尿酸正常者相比,復發(fā)的風險增加,有顯著統計學差異(χ2=19.497,P0.01)。而與腫瘤的級別、浸潤、個數比較差異無統計學意義(P0.05)。結論:本研究發(fā)現女性膀胱癌患者的血尿酸水平高于對照組女性,提示腫瘤細胞可能通過某種方式增加人體內尿酸的產生,形成利于腫瘤細胞增殖的內環(huán)境,這也可能是引起或加速膀胱癌發(fā)生發(fā)展的原因之一。高尿酸血癥與女性膀胱癌的復發(fā)關系密切,可能是女性膀胱癌的復發(fā)的危險因素之一,造成二者的相關性的原因還需要更進一步分析。伴高尿酸血癥的中老年女性膀胱癌患者,應密切隨診復查以免延誤病情。
[Abstract]:Objective: bladder cancer is a common malignant tumor in urology, and there are about 90% cases of urothelial carcinoma, among which superficial bladder carcinoma accounts for 75% 85%. The lateral wall and triangle area of bladder are the high incidence sites of bladder tumor. Tumors can exist in single or multiple forms. Bladder cancer has three important biological characteristics: local infiltration, distant metastasis, and recurrent recurrence. Occupational exposure and smoking are generally considered as the most important environmental factors related to bladder cancer. However, there is no unified view on the recurrence mechanism of bladder cancer. The related research is still in the exploratory stage, most of the clinical from the pathological characteristics of statistical analysis, such as the number of tumors, size, staging, and so on. However, the biological mechanism of bladder cancer recurrence has not been fully elucidated. It has been found that the incidence and mortality of urinary system tumors in patients with hyperuricemia have increased. Patients with urologic neoplasms associated with hyperuricemia are not uncommon, but there are few reports of the correlation between the two. We analyzed 112 women with bladder cancer and 96 patients excluded the tumor at the same time. Urinary system diseases, acute and chronic inflammation, severe liver and kidney insufficiency, hormone replacement therapy in female patients were retrospectively analyzed to explore the relationship between hyperuricemia and female bladder cancer. To provide some valuable clues for clinical diagnosis and epidemiological investigation. Methods: the clinical data of 112 female patients with bladder cancer from January 2014 to December 2016 in our hospital were collected. There were 22 cases of hyperuricemia and 90 cases of non-hyperuricemia. 96 cases of hormone replacement therapy were used as control group. The incidence of hyperuricemia and the difference of uric acid between the two groups were compared. The grade and infiltration of bladder tumors in 112 women with or without hyperuricemia were analyzed. Results: the incidence of hyperuricemia in female bladder cancer patients and control group was 19.6% and 17.7, respectively. There was no significant difference between the two groups (蠂 2 / 0.127). P0.05 ORA 0.88; However, the mean value of serum uric acid water in female patients with bladder cancer was higher than that in the control group, the difference was statistically significant (P0.05). 95 CI: 0.437 / 1.775.The risk of recurrence in female bladder cancer patients with hyperuricemia was significantly higher than that with normal uric acid (蠂 2, 19.497). There was no significant difference in the grade, invasion and number of tumor. Conclusion: the level of serum uric acid in women with bladder cancer is higher than that in women in control group. These results suggest that tumor cells may increase the production of uric acid in human body in some way and form an internal environment conducive to the proliferation of tumor cells. Hyperuricemia is closely related to the recurrence of bladder cancer in women and may be one of the risk factors for recurrence of bladder cancer in women. The causes of the correlation need to be further analyzed. The elderly women with hyperuricemia should follow up closely to avoid delay.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R737.14;R589.7
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本文編號：1480930