Background/Objectives: Bladder carcinoma (BC) is strongly associated with tobacco exposure, a major shared risk factor for several smoking-related diseases (SRDs), including pulmonary disorders and coronary atherosclerosis. However, the prevalence of SRDs in patients with high-grade (HGBC) or muscle-invasive bladder carcinoma (MIBC) has not been systematically investigated. We aimed to evaluate SRD prevalence and to assess the potential role of chest high-resolution computed tomography (HRCT) in a population with histologically confirmed HGBC or MIBC. Methods: We retrospectively analyzed 166 patients with histologically confirmed HGBC/MIBC who underwent staging HRCT. SRDs—including emphysema, suspicious pulmonary nodules, airway disease, interstitial lung disease (ILD), and coronary artery calcifications (CAC)—were assessed. Associations between smoking status and SRDs were evaluated using binary logistic regression, and odds ratios (OR) with 95% confidence intervals (CI) were calculated. Results: Overall, 60.2% of patients had at least one SRD. Smokers showed a significantly higher SRD prevalence than non-smokers (p< 0.05). Pulmonary SRDs were observed in 31.9% of patients, with emphysema being most strongly associated with smoking (p< 0.01). Suspicious pulmonary nodules (Lung-RADS ≥ 3) were detected in 6.6% of patients, more commonly among smokers (72.7%), though the difference was not statistically significant. Histological confirmation, available for 45% of these nodules, revealed primary lung cancers rather than metastatic bladder carcinoma in all verified cases. Conclusions: Patients with HGBC/MIBC demonstrate a high prevalence of SRDs, supporting the integration of chest HRCT into staging protocols. HRCT may enable early detection of clinically relevant comorbidities and help identify candidates for lung cancer screening.
背景/目的：膀胱癌与烟草暴露密切相关，而烟草暴露是多种吸烟相关疾病（包括肺部疾病和冠状动脉粥样硬化）的共同主要风险因素。然而，吸烟相关疾病在高分级或肌层浸润性膀胱癌患者中的患病率尚未得到系统研究。本研究旨在评估经组织学确诊的高分级或肌层浸润性膀胱癌人群中吸烟相关疾病的患病率，并探讨胸部高分辨率计算机断层扫描在其中的潜在作用。方法：我们回顾性分析了166例经组织学确诊并接受分期高分辨率CT检查的高分级/肌层浸润性膀胱癌患者。评估的吸烟相关疾病包括肺气肿、可疑肺结节、气道疾病、间质性肺病和冠状动脉钙化。采用二元逻辑回归评估吸烟状况与吸烟相关疾病之间的关联，并计算比值比及其95%置信区间。结果：总体而言，60.2%的患者至少患有一种吸烟相关疾病。吸烟者的吸烟相关疾病患病率显著高于非吸烟者（p<0.05）。31.9%的患者存在肺部吸烟相关疾病，其中肺气肿与吸烟的关联最为显著（p<0.01）。6.6%的患者检出可疑肺结节（Lung-RADS评分≥3），吸烟者中更为常见（72.7%），但差异无统计学意义。在可获得组织学确认的结节中（占45%），所有验证病例均证实为原发性肺癌而非膀胱癌转移。结论：高分级/肌层浸润性膀胱癌患者吸烟相关疾病患病率较高，支持将胸部高分辨率CT纳入分期检查方案。高分辨率CT有助于早期发现具有临床意义的合并症，并帮助识别适合进行肺癌筛查的候选者。
肿瘤(癌症)患者之家