The Study In Ureteral Carcinoma To Compare The Diagnostic Accuracy Of Different Auxiliary Examinations And To Influencing Factors Of Prognosis With Multifactor

Objective To compare the diagnostic accuracy and clinical value of different auxiliary examinations in the diagnosis of ureteral carcinoma,to improve diagnostic ability for the primary ureteral carcinoma.Methods The clinical data of 82 patients,who diagnosed as primary ureteral carcinoma by pathological diagnosis in the First Affiliated Hospital of Chongqing Medical University from June,2010 to June,2016,were retrospectively analyzed.The diagnostic accuracy of primary ureteral carcinoma by all auxiliary examinations,including B ultrasound,CTU,IVU,FISH,retrograde pyelography and ureterorenoscopic examination,were compared.The diagnostic accuracy of CTU and B ultrasound used widely in the different tumor stage and tumor location of ureteral carcinoma were was also compared.Results The rate of diagnostic accuracy of CTU,retrograde pyelography and ureterorenoscope examination,FISH,B ultrasound and IVU was 90.91%(60/66),81.82%(9/11),69.70%(23/33),61.11%(11/18),33.82%(23/68)and 18.75%(3/16)respectively.Among non-invasive auxiliary examinations,the rate of diagnostic accuracy of CTU was obviously higher than B ultrasound,IVU and FISH(P<0.0083),which were statistically significant.There were no statistical significance between the rate of diagnostic accuracy of CTU and B ultrasound in the different tumor stage and location of primary ureteral carcinoma(P>0.05).The rate of diagnostic accuracy of retrograde pyelography was higher than ureterorenoscopic examination among the invasive auxiliary examinations(P<0.05).Conclusion The rate of diagnostic accuracy of CTU is significantly higher than other auxiliary examinations,which can be regarded as gold criteria of imaging diagnosis for primary ureteral carcinoma.B ultrasound can be used as a preferred auxiliary examination in preliminary screening for primary ureteral carcinoma.These examinations,including IVU,FISH and retrograde pyelography,show little diagnostic value in ureteral carcinoma.Ureterorenoscopic examination is helpful to the patient with primary ureteral carcinoma,especially in patients diagnosed difficultly.Objective To discuss the risk factors which influence prognosis and the incidence of secondary bladder cancer in patients with primary ureteral carcinoma.Methods The clinical data of 58 patients were retrospectively analyzed.All patients were pathologically diagnosed with primary ureteral carcinoma in the First Affiliated Hospital of Chongqing Medical University from June,2010 to September,2017 and then treated by operation.Clinical and pathological factors,seven on prognosis and five on the incidence of secondary bladder cancer,were collected and analyzed with univariate analysis and multivariate analysis respectively.Results Univariate analysis identified three factors that were associated with prognosis:clinical stage(?2=16.441,P=0.000),histological grade of tumor(x2=6.941,P=0.008),chemotherapy or not(?2=4.934,P=0.026).But age(?2=2.013,P=0.156),gender(?2=0.414,P=0.520),method of operation(?2=6.565,P=0.010)and multifocal or unifocal tumor(?2=0.128,P=0.720)showed no significant influence on prognosis.The depth of invasion(?2=5.314,P=0.021),bladder irrigation after operation(?2=3.919 P=0.048),histological grade of tumor(?2=7.025,P=0.008)and method of operation(?2=6.565,P=0.010)were significantly associated with the incidence of secondary bladder cancer.But multifocal or unifocal tumor(x2=0.336,P=0.562)had no statistical significance on the incidence of secondary bladder cancer.Multivariate analysis identified the significant factors for prognosis of ureteral cancer were clinical stage(RR=6.545,95%CI=1.759?24.355,P=0.005)and histological grade of tumor(RR=11.322,95%CI=1.232?104.08,P=0.032).The influencing factors on the incidence of secondary bladder cancer were non radical operation(RR=3.819,95%CI=1.424?10.244,P=0.008)and high grade histological of tumor(RR=8.942,95%CI=1.175?68.056,P=0.034).Conclusions The significant factors for prognosis of ureteral cancer are clinical stage and histological grade of tumor.The significant influencing factors on the incidence of secondary bladder cancer after ureteral cancer are the method of operation and histological grade of tumor.