单中心2087例拟诊肾恶性肿瘤者行肾部分切除术后良性病变的发生率及其特点

The incidence and characteristics of benign lesions after partial nephrectomy for presumed malignant masses

目的:探讨术前诊断为肾脏恶性肿瘤的中国患者中行肾部分切除术后良性病理结果的发生率及其预测因素。方法:回顾性研究2008年1月~2015年12月术前诊断为恶性肾肿瘤,并接受开放、机器人或腹腔镜肾部分切除术的2 087例患者的基本信息、影像学及术后病理等资料,对患者分别按性别、年龄、体质指数、肿瘤大小、分侧等进行分组,运用卡方检验、logistic回归分析等统计方法分析患者的性别、年龄、肿瘤大小等预测因素与术后良性结果发生率的关系。结果:2 087例患者中,男1 544例(74.0%),女543例(26.0%),发病年龄17~85岁,平均(51.3±11.6)岁。共有43例(2.0%)为良性。分组进行卡方检验后,得知性别分组的良性发生率差异有统计学意义(P<0.001),年龄、BMI和肿瘤大小分组差异有统计学意义(P<0.05)。分组进行logistic二元回归分析得知,年龄和性别与肿瘤良性发生率呈负相关,肿瘤大小与良性发生率呈正相关。结论:术前诊断为恶性肿瘤,行肾部分切除术后良性病理结果的发生率为2.0%,较国内外同类研究明显偏低。女性、低龄、肿瘤体积大者术后良性结果的概率较其他患者为大,是良性占位病变的独立预测因素。

Objective:To explore the incidence of benign pathological results of partial nephrectomy in Chinese patients with preoperative diagnosis of renal malignancy and its predictors.Methods:We retrospectively analyzed the medical records of 2 087 patients with unilateral renal neoplasm postoperatively diagnosed as malignancy and undergoing open,robotic or laparoscopic partial nephrectomies from January 2008 to December 2015.2087 patients were divided into groups according to gender,age,BMI,tumor size,and side.Chi-square test,logistic regression and other statistical methods were done to identify association of patient's gender,age,tumor size,other factors with benign lesions.Results:2 087 patients included 1 544males(74.0%)and 543females(26.0%),and the age of onset was 17 to 85years(mean 51.3 ± 11.6years).The tumor located on the left side had 999 cases,and1 088 on the right side.The chi-square test showed that there was significant difference in the benign rate of gender group(P<0.001).Age,BMI and tumor size were statistically significant(P<0.05).The logistic binary regression analysis showed that age and sex were negatively correlated with the benign rate of tumor,and the tumor size was positively correlated with the benign rate.Conclusions:The postoperative benign probability of women,young age and large tumor is greater than other patients.