T_(1a)期肾肿瘤良性组织学结果预测因素的临床分析

Clinical analysis of the predictors of benign histology in patients with T_(1a) renal tumors

目的：探讨T1a期肾肿瘤患者肾部分切除术后良性组织学结果的相关预测因素。方法：回顾性分析2010年1月-2014年10月于青岛大学附属医院接受肾部分切除术的140例T。。期肾肿瘤患者的临床及影像学资料，并行R．E．N．A．L解剖学评分，比较年龄、性别、体质指数（BMI）、肿瘤侧别、临床症状、R．E．N．A．L评分等因素在术后良恶性病理结果中的差异，应用Logistic回归分析模型探讨相关因素与T1a期肾肿瘤良性组织学结果的关系。结果：140例患者中，良性病变12例（8．6％），其中7例（58．3％）为男性，5例（41．7％）为女性。良性病变患者平均年龄及BMI均明显小于恶性病变患者，解剖学因素中仅E评分在良恶性之间的差异有统计学意义（P〈0．05）。Logistic回归分析显示年龄（OR=1．155；95％CI：1．041～1．281；P=0．006）、BMI（OR=1．509；95％C1：1．118--2．037；P=0．007）以及E=1分（OR=0．017；95％CI：0．001～0．585；P=0．024）是术后良性组织学结果的独立预测因素。结论：本研究结果表明，年龄、BMI及肿瘤外生型生长是T1a期肾肿瘤术后良性组织学结果的独立预测因素。

Objective：To explore the predictors of benign histology in patients with T1a renal tumors undergo- ing partial nephrectomy （PN）. Method： The clinical and imaging data of 140 consecutive patients with T1a renal tumors who underwent PN in Affiliated Hospital of Qingdao University from January 2010 to October 2014, were collected and analyzed. The R. E. N. A. L nephrometry score was assessed for each patient. The difference of age, sex, body mass index （BMI）, tumor side, clinical manifestation and R. E. N. A. L score between benign and ma- lignant pathology was compared. Logistic regression analyses were used to examine the relationship between clini- cal and imaging factors and benign histology. Result,Pathological results indicated 12 （8.6 % ） benign tumors in all the 140 cases including seven （58.3%） males and five （41.7%） females. Compared with those with malignancy, patients with benign histology were younger and with lower BMI （P〈0.05）. In addition, there was significant difference between groups regarding the E score. Multivariable logistic regression analyses showed that age （OR= 1. 155; 95%CI： 1.041-1.281; P=0.006）, BMI （OR=I. 509; 95%CI. 1.118-2.037; P=0.007）, and E=I （OR=0. 017; 95%CI： 0. 001-0. 585; P=0. 024） were independent predictors of benign histology in patients with T1a renal tumors. Conclusion：The present study shows that age, BMI, and exophytic tumors are associated with benign histology in patients with T1a renal tumors undergoing PN.