影响肾癌预后的危险因素分析

Prognostic factors for renal cell carcinoma

目的探讨影响肾癌预后的因素。方法采用Kapplan-Meier法计算生存概率、logrank检验生存率差异及应用Cox模型将获得随访的62例肾细胞癌患者的性别、年龄、临床分期、病理分类、手术方式、有无免疫治疗等因素作为分析因子,计算生存率,分析预后影响因素。结果 62例患者的1年生存率为91.1%,3年生存率为78.5%,5年生存率为60.2%。单因素分析筛选出6个对肾细胞癌预后有影响的因素,分别为是TNM分期、是否有淋巴结转移、是否行根治性肾切除术、有无肿瘤细胞坏死、术后是否行免疫治疗、肿瘤病理类型。Cox多因素分析提示TNM分期、是否行根治性肾切除术、术后是否行免疫治疗为影响肾癌预后的独立因素。结论肾细胞癌患者预后与肿瘤的TNM分期、是否行肾癌根治术、术后有无行免疫治疗有关,其中肿瘤的TNM分期为危险因子,后2个因素为保护因子。

Objective To study the independent prognosis factors of survival for renal cell car-cinoma（RCC）.Methods Clinical data of 62 cases of RCC were reviewed retrospectively.The survival rates were calculated by Kapplan-Meier method,and Cox regression model was used to analyzethe relationship between the influencing factors and the prognosis.The relevant factors included sex,age,hematuria,lumbago,position,clinical staging,pathological classifica-tion,the postoperative therapy,etc.Results The survival rate at 1,3 and 5 year were 91.1%,78.5% and 60.2 % respectively.Cox regression model showed that the independent predictive factors were TNM staging,radical nephrectomy and immunotherapy.Conclusion There are certain correlation between prognosis and TNM staging,radical prostatectomy and immunotherapy.