110例睾丸生殖细胞肿瘤预后多因素分析

Multivariate Analysis of Prognostic Factors for 110 Patients of Testicular Germ Cell Tumor

目的:观察睾丸生殖细胞肿瘤的临床特征,探讨影响其预后相关因素。方法:回顾性分析2002年1月～2009年9月收治110例睾丸生殖细胞肿瘤患者的临床资料,采用Kaplan-Meier法计算生存率:应用Cox模型将110例患者资料进行统计并分析其预后的影响因素。结果:本组患者术后3年生存率为90.4%.5年生存率为86%。睾丸生殖细胞肿瘤Ⅰ期、Ⅱ期、Ⅲ期的3年生仔率分别为100%、91.6%、82.5%.5年生存率分别为96.7%、91.6%、67.1%。将AFP、HCG、临床分期和病理类型这4个单因素分析中有统计学意义的变量引入Cox比例模型进行多因素分析后,结果仅显示临床分期(P=0.018).病理类型(P=0.033)对睾丸生殖细胞肿瘤的预后有统计学意义,为睾丸生殖细胞肿瘤患者长期生存的独立影响因素。结论:睾丸生殖细胞肿瘤的预后与肿瘤的临床分期和肿瘤细胞的病理分型有关。

Objective：To explore the characteristics of testieular germ cell tumor and its influence to the prognosis. Method：Clinical date of 1l0 eases of testicuiar germ cell tumor from January 2002 to September 2005, treated in the third teaching hospital of xinjiang medical university , were reviewed retrospectively. Parameter data were obtained from 110 patients whose information was complete upon receipt of the testieufar germ cell tumor database. The survival rates were calculated by Kaplan-Meier method and Cox regression model was used to analyze the relationship of the influencing factors and the prognosis. The relevant factors including age, nation, symptom, eryptorchidism, location of tumor, smoking or not, AFP, HCG, pathol-ogical classification, clinical classification, radiation,chemotherapy, etc. All data were assessed with SPSS17.0. Result：The survival rates of 100 recipients who lived for 3 and 5 years were 90.4% and 86%, respectively. The 3-,5- year survival rates of seminomas were 96.6% and 92.3%, and the3-,5-year survival rates of non-seminomas were 86.5% and 80.2%. The 3-year survival rates of the stage Ⅰ , Ⅱand Ⅲ testicular germ cell tumors were 100%, 91.6%,82.5%, and the 5 year survival rates were 96.7%,91.6%, 67.1%. Cox regression model showed that the main predictive factors were clinical classification（ P = 0. 018）and pathological classification（ P = 0. 033）. They were the independent impact factors on the survival of patients with testieular germ cell tumor. Conclusion：There are certain correlation between clinical classification and pathological classification.