早期肾透明细胞癌患者术后预后的影响因素

Factors influencing postoperative prognosis of patients with early clear cell renal carcinoma

目的探讨早期肾透明细胞癌患者术后预后的影响因素。方法选择临床分期为pT1a或pT1b,行部分切除术或根治性切除术治疗的早期肾透明细胞癌患者283例,比较不同年龄段、临床分期及Fuhrman分级患者1、3、5年生存率,采用多因素Cox模型分析患者术后生存的影响因素。结果分期为pT1a与pT1b患者间、年龄<51岁患者与≥51岁患者间1、3、5年生存率比较,差异均无统计学意义(均P>0.05)。低Fuhrman分级组患者3、5年生存率均高于高分级组(P<0.05)。高Fuhrman分级是早期肾透明细胞癌患者术后生存的危险因素(P<0.05)。结论对于行部分切除术或根治性切除术的早期透明细胞癌患者,Fuhrman分级可作为评估其预后的重要因素,高级别的患者应加强定期复查。

Objective To explore the factors influencing the postoperative prognosis of patients with early clear cell renal carcinoma.Methods A total of 283 patients diagnosed as early clear cell renal carcinoma with clinical stage pT1a or pT1b underwent partial or radical nephrectomy. The 1-year,3-year and 5-year survival rates were compared among patients with different age stages,clinical stages,or Fuhrman grades. Multivariate Cox model was used to analyze the factors influencing the postoperative survival of the patients. Results There were no significant differences in the 1-year,3-year or 5-year survival rate between the patients with stage pT1a and pT1b,and the differences were also not found between the patients 〈51 years and the patients ≥51 years（ all P〉 0. 05）. The 3-year and 5-year survival rates of the patients with low Fuhrman grade were higher than those of the patients with high grade（ P 〈0. 05）. High Fuhrman grade was the risk factor for postoperative survival of patients with early clear cell renal carcinoma（ P 〈0. 05）. Conclusion For the patients with early clear cell renal carcinoma who receive partial or radical nephrectomy,Fuhrman grade is an important factor for prognostic evaluation.Regular review should be performed in the patients with high Fuhrman grade.