代谢综合征和肾细胞癌的相关性研究

摘要

背景与目的：代谢综合征(metabolic syndrome，MS)与肾细胞癌(renal cell carcinoma，RCC)的发生、发展有何联系尚无相关研究。该研究拟探究MS与RCC发生率及恶性程度的相关性。方法：入组398例RCC患者(透明细胞癌350例，XP11.2易位RCC 5例，乳头状RCC 16例，嫌色细胞癌27例)。160名健康体检者及32例良性肾肿瘤患者(血管平滑肌脂肪瘤21例，嗜酸细胞腺瘤8例，后肾腺瘤3例)作为对照组，计算不同人群MS的患病率，比较MS对RCC发生率及恶性程度的影响。结果：透明细胞癌患者相对于正常人群血压、体质指数(body mass index，BMI)和腰围的差异有统计学意义(P<0.05)。透明细胞癌的患者同时发生MS的概率为48%、乳头状细胞癌为33%、嫌色细胞癌为26%、XP11.2易位RCC为0%、血管平滑肌脂肪瘤为17%，而正常体检者发生MS的概率为25%。该研究人群中，MS患者同时患透明细胞癌的概率远高于非MS的患者，而这种差异并未在其他恶性肿瘤中明确体现。病理级别较高的透明细胞癌患者MS发生率较低。结论：MS患者更易发生RCC尤其是肾透明细胞癌。高Furhman分级的患者合并MS的可能性下降，提示对于高分级的患者，RCC的发生可能与代谢性因素无关。%Background and purpose:The association between metabolic syndrome (MS) and renal cell carcinoma (RCC) is still unknown. The aim of this study was to elucidate how MS correlates with the prevalence and malignancy of RCC.Methods:This study enrolled 398 RCC patients (350 clear cell RCC patients, 5 XP11.2 transloca-tion RCC patients, 16 papillary RCC patients and 27 chromophobe RCC patients), 160 normal persons, and 32 benign renal tumor patients. The metabolic status of the patients was assessed, and the link between MS and the prevalence or malignancy of RCC was calculated.Results:Clear cell RCC patients had signiifcantly higher rates of hypertension, higher body mass index (BMI) and longer waist circumference. Forty-eight percent clear cell RCC patients had MS, while the number was 33% for papillary RCC, 26% for chromophobe RCC, 0% for XP11.2, 17% for AML, and 25%for normal people. MS patients had signiifcant higher rates of having clear cell RCC than no-MS patients, however this kind of difference was not seen in other types of RCC. Clear cell RCC patients with higher Furhman grade had lower rates of MS.Conclusion:Patients with MS are more likely to develop clear cell RCC. Patients with high Furhman grade tumors have low MS rates, indicating that high grade tumor may have other originating mechanisms other than metabolic disorders.