本文選題：吸煙狀況 + 累積吸煙暴露量��； 參考：《新疆醫(yī)科大學》2017年碩士論文

【摘要】：目的:分析吸煙狀況及累積吸煙暴露量對非肌層浸潤性膀胱癌患者預后影響。方法:收集484例在我院行經(jīng)尿道膀胱腫瘤電切術(shù)的非肌層浸潤性膀胱癌患者的臨床病理資料及吸煙狀況。通過Kaplan-Meier法繪制生存曲線評估吸煙或吸煙累積暴露量對腫瘤復發(fā)的影響,應(yīng)用Cox風險回歸模型對變量進行多因素分析,計算得出影響非肌層浸潤性膀胱癌預后復發(fā)的危險因素。結(jié)果:484例患者的平均隨訪時間為34.1個月,在多因素分析中我們發(fā)現(xiàn)腫瘤的病理分級、既往復發(fā)病史、腫瘤數(shù)目、腫瘤大小均能顯著性的影響腫瘤復發(fā),吸煙狀況并不顯著性的影響腫瘤復發(fā)(p=0.066)。而在既往吸煙及當前吸煙的患者中進行多因素分析,我們發(fā)現(xiàn)腫瘤病理分級、既往復發(fā)病史、腫瘤數(shù)目、腫瘤大小、累積吸煙暴露量以及戒煙狀況均能顯著性的影響腫瘤復發(fā),且戒煙≥10年的患者在腫瘤復發(fā)的危險是當前吸煙患者0.500倍(p=0.015)。結(jié)論:吸煙狀況對非肌層浸潤性膀胱癌患者腫瘤復發(fā)的影響仍存在爭議,而在既往吸煙及當前吸煙的患者中,我們發(fā)現(xiàn)高累積吸煙暴露量可增加非肌層浸潤性膀胱癌患者的腫瘤復發(fā)風險。而患者確診膀胱癌后,長時間的戒煙(≥10年)可以降低腫瘤復發(fā)的風險。
[Abstract]:Objective: to analyze the effect of smoking status and cumulative smoking exposure on prognosis of non-myometrial invasive bladder cancer. Methods: the clinicopathological data and smoking status of 484 patients with non-muscular invasive bladder cancer undergoing transurethral resection of bladder tumor were collected. The influence of smoking or cumulative exposure to smoking on tumor recurrence was assessed by Kaplan-Meier method. The risk factors affecting the prognosis and recurrence of non-myometrial invasive bladder cancer were calculated by using Cox risk regression model and multivariate analysis. Results the mean follow-up time was 34.1 months. In the multivariate analysis, we found that the pathological grade, the history of recurrence, the number of tumor and the size of tumor could significantly affect the recurrence of tumor. Smoking status was not significantly related to tumor recurrence (P 0.066). By multivariate analysis, we found that tumor pathological grade, recurrence history, tumor number, tumor size, cumulative exposure to smoking and smoking cessation status significantly affected tumor recurrence. Patients who quit smoking for more than 10 years were 0.500 times more likely to relapse than the current smokers. Conclusion: the effect of smoking status on tumor recurrence in non-myometrial invasive bladder cancer patients is still controversial. We found that high cumulative smoking exposure increased the risk of tumor recurrence in non-myometrial invasive bladder cancer patients. After the diagnosis of bladder cancer, long-term smoking cessation (鈮，

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