PurposeWe aimed to ascertain the degree of association between bladder cancer and human papillomavirus (HPV) infection.Materials and MethodsWe performed a meta-analysis of observational studies with cases and controls with publication dates up to January 2011. The PubMed electronic database was searched by using the key words "bladder cancer and virus." Twenty-one articles were selected that met the required methodological criteria. We implemented an internal quality control system to verify the selected search method. We analyzed the pooled effect of all the studies and also analyzed the techniques used as follows: 1) studies with DNA-based techniques, among which we found studies with polymerase chain reaction (PCR)-based techniques and 2) studies with non-PCR-based techniques, and studies with non-DNA-based techniques.ResultsTaking into account the 21 studies that were included in the meta-analysis, we obtained a heterogeneity chi-squared value of Qexp=26.45 (p=0.383). The pooled odds ratio (OR) was 2.13 (95% confidence interval [CI], 1.54 to 2.95), which points to a significant effect between HPV and bladder cancer. Twenty studies assessed the presence of DNA. The overall effect showed a significant relationship between virus presence and bladder cancer, with a pooled OR of 2.19 (95% CI, 1.40 to 3.43). Of the other six studies, four examined the virus's capsid antigen and two detected antibodies in serum by Western blot. The estimated pooled OR in this group was 2.11 (95% CI, 1.27 to 3.51), which confirmed the relationship between the presence of virus and cancer.ConclusionsThe pooled OR value showed a moderate relationship between viral infection and bladder tumors.
Análisis descriptivo de una serie de 32 tumores del tracto urinario superior en un hospital de segundo nivel
ResumenIntroducción: El objetivo del estudio es analizar, basándonos en los pacientes tratados en nuestro servicio de tumores del tracto urinario superior, las características epidemiológicas y clínicas así como las variables que han influido en la evolución y mortalidad de estos pacientes. Materiales y Métodos: Se analizaron retrospectivamente 32 pacientes diagnosticados de tumores del tracto urinario superior en el Hospital comarcal Santa Ana de Motril (Granada), en el periodo comprendido entre enero del 2003 y diciembre del 2013. Resultados: La edad media fue de 72,25 años. El 75% eran hombres y el 25% mujeres. El 71.9% eran hipertensos, el 46.9% fumadores. El 18.8% presentaba un tumor vesical en el momento del diagnóstico. El 90.6% debutó con hematuria. El 53.1% se localizó en el lado derecho y el 43.8% en el izquierdo. El 25% se desarrollaron en los cálices, el 46.8% en la pelvis renal y el 50% a nivel ureteral. El estadio anatomopatológico al diagnóstico fue: 6.3% Ta, 25% T1, 28.1% T2, 37.5% T3 y 3.1% T4. El 21.9% eran grado I, el 34.4% grado II y el 43.8% grado III. No se observó recidiva tumoral en ningún paciente, siendo la mortalidad cáncer -específica del 0%. En 8 pacientes se diagnosticó un tumor vesical durante su seguimiento. La media de estancia hospitalaria fue de 7 días. Conclusiones: A pesar de ser una casuística limitada los resultados obtenidos son satisfactorios independientemente de la técnica quirúrgica empleada, al ser la supervivencia libre de enfermedad en el periodo de seguimiento del 100% y la mortalidad cáncer-específica del 0%.
AbstractIntroduction: The aim of the study is to analyze, based on patients treated in our department of upper urinary tract tumors, epidemiological and clinical characteristics as well as the variables that have influenced the evolution and mortality of these patients Material and methods: 32 patients diagnosed of upper urinary tract tumors in Santa Ana Hospital of Motril (Granada) between January 2003 and December 2013 were retrospectively analyzed. Results: The mean age was 72.25 years. 75% were male and 25% female. 71.9% were hypertensive, 46.9% were smokers. 18.8% had a bladder tumor at diagnosis. 90.6% debuted with hematuria.53.1% was located on the right side and 43.8% on the left. 25% were developed in the chalices, 46.8% in the renal pelvis and ureteral 50%.The pathologic stage at diagnosis: 6.3% Ta, 25% T1, 28.1% T2, 37.5% T3 and 3.1% T4. 21.9% were grade I, grade II 34.4% and 43.8% grade III. No tumor recurrence was observed in any patient being cancer -specific mortality of 0%. In 8 patients bladder tumor was diagnosed during follow-up. The mean hospital stay was 7 days. Conclusions: Despite being limited casuistry the results are satisfactory regardless of the surgical technique used, being disease-free survival in the follow-up period of 100% and cancer-specific mortality of 0%. Enviado: 02-12-2014 Revisado: 22-12-2014 Aceptado: 29-12-...
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