影响肾细胞癌患者预后的因素分析

Multivariate analysis of prognostic factors in renal cell carcinoma

目的 通过多因素分析 ,探讨影响肾癌预后的因素。 方法 对 316例肾癌进行回顾性分析 ,采用Kaplan Meier法对确定的单因素进行生存率的描述 ,应用Log Rank检验对有意义的单因素进行筛选 ,通过Cox比例风险模型对预后因素进行评价。 结果 平均随访时间 (40 3± 18 5 )个月 ,5年生存率 6 2 3%。通过多因素分析最终进入Cox比例风险模型的有 9个因素 ,远隔转移是最重要的影响预后的因素 (P =0 0 0 13) ,其他因素依次是分期 (P =0 0 182 )、年龄 (P =0 0 34 7)、机体表现状态 (P =0 0 42 3)、淋巴转移 (P =0 0 471)、淋巴结清扫 (P =0 0 5 42 )、细胞分级 (P =0 0 775 )、血浆白蛋白 (P =0 15 36 )、血肌酐 (P =0 45 43)。 结论 肾癌的TNM分期是最重要的影响预后的因素 ;年龄、机体表现状态对预后产生影响 ,淋巴结清扫对相对早期肾癌是有意义的。

Objective[WT5”BZ] To assess the effect of prognostic factors on renal cell carcinoma (RCC). [WT5”HZ]Me thods[WT5”BZ] 316 cases of RCC were reviewed retrospectively. Their survival rates were calculated by Kaplan Meier method and statistical differences were determined by Log rank test. Significant prognostic factors were evaluated by Cox′s multivariate proportional hazard model. [WT5”HZ]Results[WT5”BZ] After 40 3±18 5 month follow up, the overall 5 year survival rate was 62 3%. By multivariate analysis, nine factors were included in Cox′s multivariate proportional hazard model. M was the most important prognostic factor in RCC ( P =0 001?3), and the others in turn were T ( P =0 018?2), age ( P =0 034?7), performance status ( P =0 042?3), N ( P =0 047?1), lymphadenectomy ( P =0 054?2), grade ( P =0 077?5), serum albumin ( P =0 153?6), and serum creatinine ( P =0 454?3). [WT5”HZ]Conclusions[WT5”BZ] The significant prognostic factors in RCC were T, N, and M. Age and performance status showed the effect on prognosis of RCC. Lymph node dissection also revealed a meaningful effect on relative lower stage of RCC. [WT5”HZ]