BMJ:急性尿潴留与隐匿性肿瘤风险

2021-10-20 MedSci原创 MedSci原创

急性尿潴留可能是隐匿性泌尿生殖系统肿瘤、结直肠肿瘤和神经系统肿瘤的临床症状,50岁或以上急性尿潴留且无明显潜在原因的患者应考虑隐匿肿瘤风险

急性尿潴留指的是短时间内膀胱突然出现大量的尿液,并且这些尿液不能够经尿道排出,膀胱过度充盈,需要立即进行膀胱减压。男性发病率为每年每1000名人2.2-8.8例,并随着年龄的增长,发病率大幅增加。据估计,10%的70岁男性和30%的80岁男性会出现急性尿潴留。女性急性尿潴留发病率缺乏相关研究,估计女性患者比例约为男性的1/13。急性尿潴留的常见病理可分为阻塞性、感染性、炎症性、药物相关、神经系统或其他。男性最常见的病因是良性前列腺增生继发的梗阻,而逼尿肌功能异常是女性最常见的原因。近日研究人员考察了急性尿潴留后患者发生泌尿生殖系统、结直肠和神经系统肿瘤的风险。

本次研究为基于全国人群的队列研究,在丹麦所有医院开展,1995-2017年期间,总计75983名50岁或以上的急性尿潴留患者首次入院接受治疗。研究的主要终点为与一般人群相比,急性尿潴留患者后续的泌尿生殖系统、结直肠和神经系统肿瘤风险。

首次诊断为急性尿潴留后,3个月内,前列腺癌的绝对风险为5.1%(n=3198),1年时为6.7%(n=4233),5年时为8.5%(n=5217)。与一般人群相比,急性尿潴留后3个月内,每1000人随访年中,额外发生218例前列腺癌病例;在3-12个月的随访期间,额外发生21例前列腺癌病例,但超过12个月后,额外风险可忽略不计。与一般人群相比,急性尿潴留后3个月内,泌尿生殖系统肿瘤的额外风险为56/1000人年,女性生殖系统肿瘤的额外风险为24/1000人年,结直肠癌额外风险为12/1000人年,神经系统肿瘤的额外风险为2/1000人年。大多数额外风险仅限于随访三个月内,但前列腺和尿路肿瘤风险在随访3-12个月的时间内仍然增加。在女性中,浸润性膀胱癌的额外风险可持续数年。

急性尿潴留后患者肿瘤风险

研究发现,急性尿潴留可能是隐匿性泌尿生殖系统肿瘤、结直肠肿瘤和神经系统肿瘤的临床症状,50岁或以上急性尿潴留且无明显潜在原因的患者应考虑隐匿肿瘤风险

原始出处:

Maria Bisgaard Bengtsen et al. Acute urinary retention and risk of cancer: population based Danish cohort study.BMJ. 19 October, 2021.

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    2022-02-13 gaoxiaoe
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    2022-05-24 清风徐来2022
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鞍区常见肿瘤的影像鉴别诊断

鞍区常见四种大型肿瘤