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World J Urol:晚期肺癌炎性反应指数可作为接受根治性肾输尿管切除术治疗的上尿路尿路上皮癌患者的有效预后评估指标

2025-04-12 AlexYang MedSci原创 发表于重庆

ALI是接受RNU治疗的UTUC患者的重要且有用的预后预测指标。

上尿路尿路上皮癌(UTUC)较为罕见,约占所有尿路上皮癌的5%。然而,近几十年来其发病率有所上升,这可能是由于检测方法的进步以及人口老龄化所致。根治性肾输尿管切除术(RNU)是局部性UTUC的标准治疗方法,尤其是针对侵袭性和高级别疾病。由于输尿管壁较薄以及管周淋巴管广泛存在,UTUC易侵犯周围组织并发生转移。因此,UTUC的预后较差,即使对于接受RNU治疗的患者,其5年生存率也仅约为70%。

能够预测接受RNU治疗的局部性UTUC患者预后并划分风险等级的临床病理因素包括年龄、输尿管肿瘤、肾积水、高病理分期、高疾病分级以及淋巴血管侵犯(LVI)。全身性炎症反应和长期营养状况是公认的与癌症发生和发展相关的宿主相关机制。此外,中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、全身免疫炎症指数(SII)以及预后营养指数(PNI)已被提议作为接受RNU治疗的局部性UTUC患者的预后因素。

晚期肺癌炎性反应指数(ALI)是一种新型的炎症和营养生物标志物,是转移性非小细胞肺癌的有效预后指标。此外,ALI不仅是转移性疾病的预后指标,也是根治性手术后局部性癌症的预后指标。然而,ALI对局部性UTUC的疗效尚未得到充分评估。ALI是根据体重指数(BMI)、血清白蛋白水平和NLR计算得出的,可用于综合评估炎症和营养状况。相比之下,其他指标(如NLR、PLR、SII和PNI)仅反映炎症状况或营养状况。因此,研究人员假设ALI与局部性UTUC患者的预后相关,并且是预后不良的强预测因子

近日,来自日本广岛大学等机构的研究人员评估了ALI对接受RNU治疗的UTUC患者预后的预测能力,并将其与其他炎症或营养指数作为预后指标进行比较。

 

 

研究人员回顾性评估了2010年1月至2024年4月期间在多中心接受RNU治疗的UTUC患者。研究人员计算了患者的术前ALI,并将患者分为低ALI组和高ALI组。研究使用1:1倾向评分匹配(PSM)调整两组之间的临床病理差异。研究人员采用Kaplan-Meier方法比较了低ALI组和高ALI组的总生存期(OS)和无复发生存期(RFS)。此外,研究人员还使用多元Cox比例风险回归分析评估了ALI作为OS和RFS的预测因子。

 

高ALI组与低ALI组接受RNU患者的生存曲线比较

结果显示,在488例患者中(其中低ALI组占48.3%),每组有160例患者匹配成功。Kaplan-Meier分析显示,低ALI组的OS(p=0.009)和RFS(p=0.006)均显著短于高ALI组。根据包含临床病理预后指标的多元分析,低ALI是OS较差(p=0.014)和RFS较差(p=0.038)的独立预测因子。此外,根据包含其他炎症或营养指数的多元分析,ALI是OS较差(p=0.024)和RFS较差(p=0.044)的独立预测因子。

该研究结果表明,ALI是接受RNU治疗的UTUC患者的重要且有用的预后预测指标。

原始出处:

Hatayama T, Goto K, Kohada Y, Nishida K, Ueno T, Furutani T, Hashimoto K, Takemoto K, Naito M, Miyamoto S, Kobatake K, Sekino Y, Kitano H, Goriki A, Hieda K, Hinata N. The advanced lung cancer inflammation index as a useful prognostic indicator for patients who underwent radical nephroureterectomy for upper tract urothelial carcinoma. World J Urol. 2025 Feb 20;43(1):132. doi: 10.1007/s00345-025-05505-8. PMID: 39976660; PMCID: PMC11842494.

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[AttachmentFileName(sort=1, fileName=m6 345_2025_Article_5505.pdf)] GetArticleByIdResponse(id=e0398e16229a, projectId=1, sourceId=null, title=World J Urol:晚期肺癌炎性反应指数可作为接受根治性肾输尿管切除术治疗的上尿路尿路上皮癌患者的有效预后评估指标, articleFrom=MedSci原创, journalId=6479, copyright=原创, creationTypeList=[1], summary=ALI是接受RNU治疗的UTUC患者的重要且有用的预后预测指标。, cover=https://img.medsci.cn/20241211/1733915003495_8538692.png, authorId=0, author=AlexYang, originalUrl=, linkOutUrl=, content=<p>上尿路尿路上皮癌(UTUC)较为罕见,约占所有尿路上皮癌的5%。然而,近几十年来其发病率有所上升,这可能是由于检测方法的进步以及人口老龄化所致。根治性肾输尿管切除术(RNU)是局部性UTUC的标准治疗方法,尤其是针对侵袭性和高级别疾病。由于输尿管壁较薄以及管周淋巴管广泛存在,UTUC易侵犯周围组织并发生转移。因此,UTUC的预后较差,即使对于接受RNU治疗的患者,其5年生存率也仅约为70%。</p> <p>能够预测接受RNU治疗的局部性UTUC患者预后并划分风险等级的临床病理因素包括年龄、输尿管肿瘤、肾积水、高病理分期、高疾病分级以及淋巴<a href="https://www.medsci.cn/guideline/list.do?q=%E8%A1%80%E7%AE%A1">血管</a>侵犯(LVI)。全身性炎症反应和长期营养状况是公认的与癌症发生和发展相关的宿主相关机制。此外,中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、全身<a href="https://www.medsci.cn/guideline/search?keyword=%E5%85%8D%E7%96%AB">免疫</a>炎症指数(SII)以及预后营养指数(PNI)已被提议作为接受RNU治疗的局部性UTUC患者的预后因素。</p> <p>晚期<a href="https://www.medsci.cn/search?q=%E8%82%BA%E7%99%8C&amp;sort_type=1&amp;search_type=1&amp;page=1">肺癌</a>炎性反应指数(ALI)是一种新型的炎症和营养生物标志物,是转移性<a href="https://www.medsci.cn/topic/show?id=32af9938ec6">非小细胞肺癌</a>的有效预后指标。此外,ALI不仅是转移性疾病的预后指标,也是根治性手术后局部性癌症的预后指标。然而,ALI对局部性UTUC的疗效尚未得到充分评估。ALI是根据体重指数(BMI)、血清白蛋白水平和NLR计算得出的,可用于综合评估炎症和营养状况。相比之下,其他指标(如NLR、PLR、SII和PNI)仅反映炎症状况或营养状况。因此,研究人员假设ALI与局部性UTUC患者的预后相关,并且是预后不良的强<a href="https://www.medsci.cn/topic/show?id=25dc1002255e">预测因子</a>。</p> <p>近日,来自日本广岛大学等机构的研究人员<strong>评估了ALI对接受RNU治疗的UTUC患者预后的预测能力,并将其与其他炎症或营养指数作为预后指标进行比较。</strong></p> <p>&nbsp;</p> <p style="text-align: center;"><img class="wscnph" src="https://img.medsci.cn/20250411/1744385625411_1935437.jpg" /></p> <p>&nbsp;</p> <p>研究人员回顾性评估了2010年1月至2024年4月期间在多中心接受RNU治疗的UTUC患者。研究人员计算了患者的术前ALI,并将患者分为低ALI组和高ALI组。研究使用1:1倾向评分匹配(PSM)调整两组之间的临床病理差异。研究人员采用Kaplan-Meier方法比较了低ALI组和高ALI组的总生存期(OS)和无复发生存期(RFS)。此外,研究人员还使用多元Cox比例风险回归分析评估了ALI作为OS和RFS的预测因子。</p> <p>&nbsp;</p> <p style="text-align: center;"><img class="wscnph" src="https://img.medsci.cn/20250411/1744385642262_1935437.jpg" /></p> <p style="text-align: center;"><span style="font-size: 12px;">高ALI组与低ALI组接受RNU患者的生存曲线比较</span></p> <p>结果显示,在488例患者中(其中低ALI组占48.3%),每组有160例患者匹配成功。Kaplan-Meier分析显示,低ALI组的OS(p=0.009)和RFS(p=0.006)均显著短于高ALI组。根据包含临床病理预后指标的多元分析,低ALI是OS较差(p=0.014)和RFS较差(p=0.038)的独立预测因子。此外,根据包含其他炎症或营养指数的多元分析,ALI是OS较差(p=0.024)和RFS较差(p=0.044)的独立预测因子。</p> <p>该研究结果表明,<strong>ALI是接受RNU治疗的UTUC患者的重要且有用的预后预测指标。</strong></p> <p><span style="font-size: 12px; color: #808080;">原始出处:</span></p> <p><span style="font-size: 12px; color: #808080;">Hatayama T, Goto K, Kohada Y, Nishida K, Ueno T, Furutani T, Hashimoto K, Takemoto K, Naito M, Miyamoto S, Kobatake K, Sekino Y, Kitano H, Goriki A, Hieda K, Hinata N. The advanced lung cancer inflammation index as a useful prognostic indicator for patients who underwent radical nephroureterectomy for upper tract urothelial carcinoma. World J Urol. 2025 Feb 20;43(1):132. doi: 10.1007/s00345-025-05505-8. PMID: 39976660; PMCID: PMC11842494.</span></p>, belongTo=, tagList=[TagDto(tagId=84577, tagName=上尿路尿路上皮癌), TagDto(tagId=503453, tagName=晚期肺癌炎性反应指数), TagDto(tagId=503454, tagName=根治性肾输尿管切除术)], categoryList=[CategoryDto(categoryId=26, categoryName=泌尿外科, tenant=100), CategoryDto(categoryId=84, categoryName=研究进展, tenant=100), CategoryDto(categoryId=20656, categoryName=梅斯医学, tenant=100)], articleKeywordId=0, articleKeyword=, articleKeywordNum=6, guiderKeywordId=0, guiderKeyword=, guiderKeywordNum=6, opened=1, paymentType=1, paymentAmount=0, recommend=0, recommendEndTime=null, sticky=0, stickyEndTime=null, allHits=856, appHits=13, showAppHits=0, pcHits=29, showPcHits=843, likes=0, shares=8, comments=5, approvalStatus=1, publishedTime=Sat Apr 12 17:42:00 CST 2025, publishedTimeString=2025-04-12, pcVisible=1, appVisible=1, editorId=6556108, editor=泌尿新前沿, waterMark=0, formatted=0, deleted=0, version=3, createdBy=9b2e1935437, createdName=AlexYang, createdTime=Fri Apr 11 23:36:23 CST 2025, updatedBy=92910, updatedName=rayms, updatedTime=Sat Apr 12 17:43:24 CST 2025, ipAttribution=重庆, attachmentFileNameList=[AttachmentFileName(sort=1, fileName=m6 345_2025_Article_5505.pdf)], guideDownload=1, surveyId=null, surveyIdStr=null, surveyName=null, pushMsXiaoZhi=true)
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    2025-04-13 屋顶瞄爱赏月 来自贵州省

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    上尿路尿路上皮癌手术切除

    0

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    2025-04-12 ms4000001513304915 来自广东省

    上尿路尿路上皮癌(UTUC)较为罕见,约占所有尿路上皮癌的5%。然而,近几十年来其发病率有所上升

    0

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    2025-04-12 刘桂林 来自辽宁省

    #期刊论坛#感谢老师分享的内容

    0

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由于整体而言上尿路尿路上皮癌(UTUC)发病率相对较低,在疾病诊断和治疗策略中还有一些存在争议之处。为提高泌尿外科医生对该病的诊疗水平,规范临床操作,中国医师协会泌尿外科医师分会肿瘤专业委员会、中国医师协会泌尿外科医师分会上尿路尿路上皮癌(CUDA—UTUC)协作组组织相关专家,结合国外相关指南、国内外近年的报道和我国临床诊疗现状,编制此共识。

BMC Urol:慢性肾功能损害可预测接受根治性肾切除术治疗的上尿路尿路上皮癌患者的肿瘤预后

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上尿路尿路上皮癌外科治疗中国专家共识

上尿路尿路上皮癌(UTUC)并不常见,约占所有尿路上皮癌的5% ~10%,其中肾盂癌约为输尿管癌的2倍。初诊时约有17%患者合并膀胱癌,术后22%~47%患者继发膀胱癌,2%~6%出现对侧上尿路复发。上尿路尿路上皮癌初诊时约60%为浸润性肿瘤,远高于膀胱癌的15%~25%。其高发年龄段在70~90岁,男性发病率为女性3倍。外科治疗是UTUC最主要的治疗方式,包括保肾手术、根治性肾输尿管切除术、淋巴