| ObjectiveThe clinical data of patients with urothelial bladder neoplasm treated by surgical operation were collected retrospectively,and the clinic-pathological characteristics of the patients with and without diabetes mellitus were compared and analyzed,so as to provide some reference for clinical diagnosis and treatment.MethodsIn the information department,the hospital ID of the patients in our hospital who were hospitalized for bladder neoplasm from January 2014 to February 2019 was retrieved,and the patients’ information was searched one by one through the micro medical record system.Patients with primary urothelial bladder neoplasm diagnosed by pathology after the first surgical operation were selected as the research objects.The patients were divided into two groups according to whether they were complicated with diabetes mellitus.The data of age,gender,education level,smoking history,drinking history,body mass index,main symptoms,duration of disease,history of urinary tract infection,history of prostate hyperplasia,history of hypertension,admission blood pressure,laboratory related examination results,as well as the size,number,pathological grade and stage of tumor,were compared and analyzed.Results1.There were 651 subjects included in this study,including 536 males and 115 females,the ratio of males to females was 4.7:1.The average age of patients was 60.94 ± 13.41 years old,and the ratio of patients over 60 years old was 59.30%.Among all the patients with bladder neoplasms,the proportion of malignant tumors in the elderly group(94.82%)was higher than that in the middle-aged group(88.29%)and the young group(76.74%),the difference was statistically significant(P < 0.05);among the patients with bladder cancer,the proportion of high grade carcinoma in the elderly group(41.80%)was higher than that in the middle-aged group(30.10%)and the young group(15.15%),the difference was statistically significant(P < 0.05)2.The average age of DM group(66.96 ± 8.56 years old)was significantly higher than that of No-DM group(60.14 ± 13.74 years old).Isolated hematuria was the most common chief complaint in DM group and No-DM group,accounting for 50.65% and 58.71%respectively;there was no significant difference in the composition of sex,education level,smoking,drinking,BMI,chief complaint,duration of disease,urinary tract infection and prostatic hyperplasia between the two groups(P > 0.05).3.The serum creatinine,urea and cystatin C in DM group were significantly higher than those in No-DM group,and the activated partial thromboplastin time was significantly shorter than that in No-DM group(P < 0.05).There was no significant difference in white blood cell count,proportion of neutrophils,red blood cell count,hemoglobin concentration,platelet count,alanine aminotransferase,aspartate transaminase,alkaline phosphatase,albumin,total bilirubin,prothrombin time,urine specific gravity,urine p H,urine red blood cells,urine white blood cells and urine protein(P > 0.05).4.There was no significant difference between DM group and No-DM group in tumor classification,tumor number and tumor size(P > 0.05).The analysis of bladder cancer subgroup showed that the proportion of high grade carcinoma in DM group was higher than that in No-DM group(52.8% vs 34.2%,P = 0.007);However,there was no significant difference between the two groups in tumor stage,tumor number and tumor size(P > 0.05).Multivariate logistic regression analysis showed that age(P < 0.05)and diabetes mellitus(P = 0.023)were independent factors influencing the grade of bladder cancer,while gender,smoking,hypertension and BMI had no significant effect on the grade of bladder cancer(P >0.05).5.There was no significant difference between DM group and No-DM group in perioperative safety such as national nosocomial infections surveillance scales(NNIS),duration of surgery,indwelling urinary catheter days,antimicrobial use days,and hospitalization days(P > 0.05).Conclusions1.The male patients of bladder neoplasms was more than female.The prevalence and malignancy of bladder neoplasms were higher in the elderly.2.There may be a certain correlation between diabetes mellitus and bladder neoplasms.Between patients of bladder cancer,those with DM are older and have higher proportion of high grade carcinoma compared with those without DM.3.DM has no significant effect on the perioperative safety of patients with bladder neoplasms undergoing TURBT.Objective Based on the method of evidence-based medicine,this meta-analysis was made on the results of previous studies published on the prognosis of patients with bladder cancer after surgery.The purpose of this study is to explore the influence of diabetes mellitus on the prognosis of patients with bladder cancer after operation,and to provide some reference for the clinical diagnosis and treatment of bladder cancer.Methods Pub Med,Web of Science,Ovid MEDLINE,Cochrane Library,CNKI,CBM and WANFANG databases were electronically searched from the establishment of the database to December 2019.According to the inclusion and exclusion criteria,prospective or retrospective cohort studies were collected to explore the effect of diabetes mellitus on the prognosis of patients with bladder cancer who was treated with transurethral resection of bladder tumor(TURBT)or radical cystectomy(RC).After literature screening,data extraction and quality evaluation of the studies,the meta-analysis was conducted with Stata 15.0 software.Results Thirteen cohort studies with 5871 patients were included,involving 974 cases of diabetes mellitus and 4897 cases of non-diabetes mellitus.Meta-analysis showed that diabetes mellitus increased the risk of recurrence(HR = 1.66,95% CI: 1.45~1.91,P < 0.001)and progression(HR = 2.42,95% CI: 1.91~3.07,P < 0.001)in patients with bladder cancer after TURBT,and also increased the risk of overall mortality(HR = 1.38,95% CI: 1.21~1.57,P < 0.001)and cancer specific mortality(HR = 1.69,95%CI: 1.36~2.10,P < 0.001)in patients with RC.There was statistically significant differences between two groups.Sensitivity analysis showed that the study was stable,and funnel plot showed no significant publication bias.Conclusions Diabetes mellitus will increase the risk of recurrence and progression of patients with bladder cancer after TURBT,and also increase the risk of overall mortality and cancer specific mortality in patients with RC,leading to poor prognosis of patients after surgical operation. |
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