Significance of lymphovascular invasion in pT1 squamous differentiated bladder urothelial carcinoma / 国际生物医学工程杂志

ABSTRACT

Objective To systematically evaluate the prognostic significance of lymphovascular invasion (LVI) in pT1 stage bladder urothelial carcinoma with squamous differentiation. Methods The clinical and patholog-ical data of 105 patients with pT1 stage urothelial carcinoma with squamous differentiation and transurethral resec-tion of bladder tumor (TURBT) were retrospectively analyzed. Hematoxylin-eosin staining and immunohistochemical staining were used to determine the presence of LVI in tumor tissues. All patients were divided into LVI-negative group and LVI-positive group according to LVI. The relationship between LVI and clinicopathological features and 5-year cancer-specific survival (CSS) rate was analyzed. Patients with relapse were divided into TURBT group and radi-cal cystectomy (RC) group according to the surgical method, and the effects of the methods on CSS were compared. Results There are 57 patients (27.6％) had LVI. In the LVI-negative group, the 5-year CSS was 84.9％, while that in the LVI-positive group was 58.4％, the difference was statistically significant(P<0.05). Univariate analysis showed that tumor multiple appearance, tumor size, recurrence and LVI were significantly correlated with CSS (all P<0.05). Multivariate analysis showed that tumor size and LVI had significant effects on CSS (all P<0.05). In the relapsed pa-tients with LVI-positive, RC had a higher CSS than TURBT (P=0.042). In the relapsed patients with LVI-negative, the difference between the two methods was not statistically significant (P=0.692). Conclusions LVI is an important prognostic factor in pT1 stage urothelial carcinoma with squamous differentiation. Patients with LVI and tumor size>3 cm have a higher risk of death. Patients with pT1 stage urothelial carcinoma with squamous differentiation, espe-cially those with LVI, should be treated with RC as soon as possible.