经尿道等离子电切术联合吡柔比星膀胱灌注治疗腺性膀胱炎后复发的影响因素及其风险预测

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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.

Key words： cystitis glandularis transurethral plasma electrosurgery pirarubicin perfusion chemotherapy relapse risk prediction

Received: 02 November 2023

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	YUAN Jincheng
	DU Yabin
	LI Fanglong
	MENG Xiaodong
	ZHAO Xinhong

Cite this article:

YUAN Jincheng,DU Yabin,LI Fanglong等. Influencing factors and risk prediction of recurrence after transurethral plasma electrocautery combined with pirarubicin bladder instillation in treatment of glandular cystitis[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(3): 209-213.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2024/V35/I3/209

[6]	罗超. 经尿道等离子电切术联合膀胱灌注治疗腺性膀胱炎的效果分析[J].中国现代医生, 2020, 58(18):110-113.
[1]	陈志强, 姚友生, 张鹏, 等. 腺性膀胱炎临床诊断和治疗中国专家共识[J].中华泌尿外科杂志, 2020, 41(8):566-568.
[7]	容伟超,陈国威,区文贵.经尿道等离子电切病灶加膀胱灌注吡柔比星预防腺性膀胱炎复发的临床研究[J].中国内镜杂志, 2012, 18(3):288-290.
[2]	Lou M. Effect of transurethral resection combined with iodophor intravesical instillation for cystitis glandulanris[J].J Aerospace Med, 2017, 28(10): 122-1223.
[8]	吕双喜, 曾凡雄, 邵魁卿,等. 中西医结合治疗腺性膀胱炎研究进展[C]//中国中西医结合学会泌尿外科专业委员会第十四次全国学术会议暨2016年广东省中西医结合学会泌尿外科专业委员会学术年会. 2016.
[3]	洪英楷, 林明恩, 吴华涛. TNF-α调控转录因子FoxM1在膀胱癌及腺性膀胱炎中的表达及意义[J].海南医学院学报, 2020, 26(3):204-208.
[9]	刘杰, 丁宁, 宁刚. 腺性膀胱炎的分型与诊治研究进展[J].黑龙江医学, 2022, 46(13):1663-1665.
[4]	刘宏刚. 经尿道等离子针状电极整块切除治疗腺性膀胱炎的疗效及安全性分析[D].天津:天津医科大学, 2020.
[10]	邱晓拂, 张化儒, 罗友华,等. 经尿道直出绿激光汽化术与经尿道双极等离子电切术治疗腺性膀胱炎的比较研究[J].中华泌尿外科杂志, 2018, 39(1):57-60.
[5]	屈伟. 经尿道电切术联合术后吡柔比星膀胱灌注治疗腺性膀胱炎的临床研究[J].中国生化药物杂志, 2017, 37(11):459-463.
[11]	王哲,张敬,孙祖刚,等.吡柔比星膀胱灌注化疗对浅表性膀胱癌术后患者血清相关因子的影响[J].河北医学, 2018, 24(1):139-142.
[6]	罗超. 经尿道等离子电切术联合膀胱灌注治疗腺性膀胱炎的效果分析[J].中国现代医生, 2020, 58(18):110-113.
[12]	秦晓平,詹雄宇,陈奇彪,等.小檗碱增强丝裂霉素C诱导的膀胱癌T24细胞周期阻滞及凋亡[J].中国病理生理杂志, 2018, 34(6):1025-1030.
[7]	容伟超,陈国威,区文贵.经尿道等离子电切病灶加膀胱灌注吡柔比星预防腺性膀胱炎复发的临床研究[J].中国内镜杂志, 2012, 18(3):288-290.
[13]	Hu J, Li C, Guo X,et al. Development and validation of a predictive nomogram for the risk of recurrence in patients with cystitis glandularis[J].Ann Transl Med, 2020, 8(6):352.
[8]	吕双喜, 曾凡雄, 邵魁卿,等. 中西医结合治疗腺性膀胱炎研究进展[C]//中国中西医结合学会泌尿外科专业委员会第十四次全国学术会议暨2016年广东省中西医结合学会泌尿外科专业委员会学术年会. 2016.
[14]	周大海, 张金平, 李景勤,等. 经尿道等离子电切联合术后吡柔比星膀胱灌注治疗腺性膀胱炎[J].实用医药杂志, 2015, 32(7):597-6020.
[9]	刘杰, 丁宁, 宁刚. 腺性膀胱炎的分型与诊治研究进展[J].黑龙江医学, 2022, 46(13):1663-1665.
[15]	张国红. 吡柔比星联合经尿道等离子电切术治疗腺性膀胱炎的临床效果与复发情况[J].中国实用医药, 2017, 12(26):143-144.
[10]	邱晓拂, 张化儒, 罗友华,等. 经尿道直出绿激光汽化术与经尿道双极等离子电切术治疗腺性膀胱炎的比较研究[J].中华泌尿外科杂志, 2018, 39(1):57-60.
[16]	邰雯雯, 周万里, 杨阳. 腺性膀胱炎复发风险预测模型的建立和验证[J].国际泌尿系统杂志, 2022, 42(6):972-976.
[11]	王哲,张敬,孙祖刚,等.吡柔比星膀胱灌注化疗对浅表性膀胱癌术后患者血清相关因子的影响[J].河北医学, 2018, 24(1):139-142.
[17]	李利军. 耳针联合八正散及丝裂霉素膀胱灌注治疗腺性膀胱炎效果及对血清Survivin,p53水平的影响[J].现代中西医结合杂志, 2018, 27(18):1968-1971.
[12]	秦晓平,詹雄宇,陈奇彪,等.小檗碱增强丝裂霉素C诱导的膀胱癌T24细胞周期阻滞及凋亡[J].中国病理生理杂志, 2018, 34(6):1025-1030.
[18]	王晨静, 李超, 咸娴,等. ARID1APIK3CAKi-67在不同病变级别浸润性膀胱尿路上皮癌中的表达及对肿瘤复发的影响[J].中国性科学, 2022, 31(2):28-32.
[13]	Hu J, Li C, Guo X,et al. Development and validation of a predictive nomogram for the risk of recurrence in patients with cystitis glandularis[J].Ann Transl Med, 2020, 8(6):352.
[19]	方新颜, 顾颖慧, 施艳琳. 角蛋白7和p53蛋白与膀胱癌临床病理的相关性及预测复发风险的价值[J].医学临床研究, 2022, 39(11):1694-1697.
[14]	周大海, 张金平, 李景勤,等. 经尿道等离子电切联合术后吡柔比星膀胱灌注治疗腺性膀胱炎[J].实用医药杂志, 2015, 32(7):597-6020.
[20]	苏醒, 高学林, 马帅军,等. 腺性膀胱炎患者经尿道病损电切术后复发的危险因素[J].现代泌尿外科杂志, 2022, 27(8):635-640.
[15]	张国红. 吡柔比星联合经尿道等离子电切术治疗腺性膀胱炎的临床效果与复发情况[J].中国实用医药, 2017, 12(26):143-144.
[21]	陈跃东, 曾彦恺, 白培德,等. 炎症细胞在女性腺性膀胱炎膀胱黏膜下的浸润情况及临床意义[J].中华泌尿外科杂志, 2018, 39(8):569-572.
[16]	邰雯雯, 周万里, 杨阳. 腺性膀胱炎复发风险预测模型的建立和验证[J].国际泌尿系统杂志, 2022, 42(6):972-976.
[22]	苗康,袁宝,王德鑫.复方苦参注射液联合羟喜树碱膀胱灌注治疗电切术后腺性膀胱炎临床观察[J].辽宁中医杂志, 2020, 47(9):97-99.
[17]	李利军. 耳针联合八正散及丝裂霉素膀胱灌注治疗腺性膀胱炎效果及对血清Survivin,p53水平的影响[J].现代中西医结合杂志, 2018, 27(18):1968-1971.
[23]	Qu Y, Chen X, Cui Y,et al. Changes of bladder mucosal inflammatory factors and prognosis in cystitis glandularis[J].Int J Clin Exp Pathol, 2018, 11(7):3591-3597.
[18]	王晨静, 李超, 咸娴,等. ARID1APIK3CAKi-67在不同病变级别浸润性膀胱尿路上皮癌中的表达及对肿瘤复发的影响[J].中国性科学, 2022, 31(2):28-32.
[24]	Yuk H D, Ku J H. Role of systemic inflammatory response markers in urothelial carcinoma[J].Front Oncol, 2020, 10(21):1473.
[25]	顾建华, 刘芳, 赵朱军,等. 红细胞分布宽度与腺性膀胱炎患者术后3年复发的相关性研究[J].医学研究杂志, 2017, 46(9):88-90.
[19]	方新颜, 顾颖慧, 施艳琳. 角蛋白7和p53蛋白与膀胱癌临床病理的相关性及预测复发风险的价值[J].医学临床研究, 2022, 39(11):1694-1697.
[20]	苏醒, 高学林, 马帅军,等. 腺性膀胱炎患者经尿道病损电切术后复发的危险因素[J].现代泌尿外科杂志, 2022, 27(8):635-640.
[21]	陈跃东, 曾彦恺, 白培德,等. 炎症细胞在女性腺性膀胱炎膀胱黏膜下的浸润情况及临床意义[J].中华泌尿外科杂志, 2018, 39(8):569-572.
[22]	苗康,袁宝,王德鑫.复方苦参注射液联合羟喜树碱膀胱灌注治疗电切术后腺性膀胱炎临床观察[J].辽宁中医杂志, 2020, 47(9):97-99.
[23]	Qu Y, Chen X, Cui Y,et al. Changes of bladder mucosal inflammatory factors and prognosis in cystitis glandularis[J].Int J Clin Exp Pathol, 2018, 11(7):3591-3597.
[24]	Yuk H D, Ku J H. Role of systemic inflammatory response markers in urothelial carcinoma[J].Front Oncol, 2020, 10(21):1473.
[25]	顾建华, 刘芳, 赵朱军,等. 红细胞分布宽度与腺性膀胱炎患者术后3年复发的相关性研究[J].医学研究杂志, 2017, 46(9):88-90.