肾透明细胞癌患者预后危险因素分析

Analysis on the prognostic risk factors in patients with clear cell renal cell carcinoma

目的探讨术前纤维蛋白原和血小板计数在预测肾透明细胞癌患者(CCRCC)预后中的价值。方法回顾性分析我院2005年1月至2015年1月行手术治疗的300例非转移性CCRCC患者的临床资料。应用Kaplan-Meier法和Log-rank检验进行单因素生存分析,比较患者临床病理特征与肿瘤特异性生存(CSS)和无复发生存(RFS)的关系,应用Cox比例风险回归模型进行独立危险因素分析,筛选与CSS和RFS有关的独立危险因素。结果单因素分析结果显示,纤维蛋白原是以CSS和RFS为终点事件的预后因素(P<0.001,P<0.001)。血小板计数是以RFS为终点事件的预后因素(P<0.001)。多因素分析结果显示,纤维蛋白原是以CSS和RFS为终点事件的独立预后因素(P<0.001,P=0.029)。血小板计数是以RFS为终点事件的独立预后因素(P=0.015)。结论术前纤维蛋白原和血小板计数是CCRCC患者预后的独立影响因子,对预后评估具有十分重要的临床意义。

Objective To explore the value of preoperative fibrinogen and platelet count in predicting the prognosis of clear cell renal cell carcinoma(CCRCC).Methods The clinical data of 300 cases of patients with non-metastatic CCRCC who underwent surgical treatment in our hospital from January 2005 to January 2015 were retrospectively analyzed.The univariate survival analysis was performed by Kaplan-Meier method and Log-rank test,and the correlation between the clinicopathological features and the cancer-specific survival(CSS)and recurrence-free survival(RFS)was compared.Cox proportional hazards regression model was used to analyze independent risk factors,and the independent risk factors related to CSS and RFS were screened.Results Univariate analysis showed that fibrinogen was a prognostic factor with cancer-specific survival(CSS)and recurrence-free survival(RFS)as end points(P<0.001,P<0.001).Platelet count was a prognostic factor of RFS as an end point(P<0.001).Multivariate analysis showed that fibrinogen was an independent prognostic factor with CSS and RFS as end points(P<0.001,P=0.029).Platelet count was an independent prognostic factor with RFS as an end point(P=0.015).Conclusion Preoperative fibrinogen and platelet count are independent impacting factors on the prognosis of patients with CCRCC,which are of great clinical significance for prognosis evaluation.