Influencing factors and risk prediction of recurrence after transurethral plasma electrocautery combined with pirarubicin bladder instillation in treatment of glandular cystitis
YUAN Jincheng, DU Yabin, LI Fanglong, MENG Xiaodong, ZHAO Xinhong
Department of Urology, No. 980 Hospital of PLA Joint Logistics Support Force, Shijiazhuang 050082, China
Abstract：Objective To investigate the effect of transurethral plasma electrosurgery combined with pirarubicin bladder instillation on the recurrence of cystitis glandularis (CG) and its risk prediction value. Methods The clinical data of 240 CG patients admitted to the 980th Hospital of the PLA Joint Logistics Support Force from August 2017 to August 2020 who underwent parallel transurethral plasma electrocautery followed by piroxicam bladder perfusion chemotherapy were retrospectively analyzed. The patients’ recurrence was analyzed, the clinical data of recurrent and non-recurrent patients were compared, the risk factors of CG recurrence were analyzed by logistic multifactorial regression and a risk model was established, and the predictive efficacy of the risk model was assessed by plotting the subjects’ operating characteristics (ROC) curves. Results There were 34 cases of CG recurrence, with a recurrence rate of 14.17%. The proportion of patients with age, RDW, NLR, and urinary tract infection, urinary stones, high-risk type, intestinal chemosis type, and diffuse type was higher in the recurrence group than in the non-recurrence group (P<0.05). Clinical staging [OR=4.335, 95%CI 2.470-7.607], pathological type [OR=1.709, 95%CI 1.059-2.757], red blood cell distribution width (RDW) [OR=1.799, 95%CI 1.173-2.757], and neutrophil to lymphocyte ratio (NLR) [OR=1.900, 95%CI 1.282-2.818] were independent risk factors for the recurrence of CG after transurethral plasma electrosurgery combined with pirarubicin bladder perfusion chemotherapy (P<0.05). The area under the curve (AUC) of the risk model predicting CG recurrence was 0.843 (95% CI: 0.791-0.887), with an optimal threshold of 0.221, and a sensitivity of 67.5% and specificity of 87.9%. Conclusions Transurethral plasma electrosurgery combined with pirarubicin bladder instillation can reduce CG recurrence, but the recurrence rate is still high and cannot benefit the patients significantly. Clinical staging, pathologic type, RDW, and NLR are the main risk factors for CG recurrence, and the establishment of a risk model has a certain predictive value for CG recurrence.
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2024, Vol. 35 
