术前二十二碳六烯酸水平与肾癌患者术后预后的关系分析

摘要

目的 探究肾癌患者术前血清二十二碳六烯酸(docosahexaenoic acid, DHA)水平与术后预后的相关性.方法 选取2004年10月至2014年10月期间140例肾癌患者,分为高DHA组(n=110,患者DHA水平≥3.81%)和低DHA组(n=30,患者DHA水平<3.81%),收集患者的基本临床病理数据,测定患者术前、术后血清DHA水平,以评估相关性.结果 高DHA组患者M1期的比率显著低于低DHA组患者(P<0.05);Kaplan-Meier分析发现,高DHA组患者的癌症-特异生存率显著高于低DHA组患者(P=0.005);多变量Cox比例风险模型分析发现,恶病体质(HR=4.973,95% CI:0.136~7.851,P=0.009)、M1(HR=3.209,95% CI:1.113~4.386,P=0.023)、低DHA(HR=3.891,95% CI:0.360~8.225,P=0.021)是肾癌患者癌症-特异生存率的显著危险因素.术前DHA水平与术后DHA水平差异无统计学意义(P>0.05).结论 术前DHA水平可以作为肾癌患者术后的独立预测因子.%Objective The study mainly described the correlation of preoperative DHA level and postoperative prognosis of renal cancer patients.Methods Our study collected 140 kidney cancer patients between 2004-2014, which were divided into high DHA group (n=110, patients' DHA level ≥3.81%) and low DHA group (n=30, patients' DHA level <3.81%), collected the datum for basic clinical pathological characteristics, and measured the preoperative and postoperation serum DHA level of renal cancer patients, to assess the correlation.Results In the study, we found that the M1 stage rate in high DHA group patients were significantly lower than the low DHA group patients (P<0.05).Kaplan-Meier analysis found that the cancer-specific survival of high DHA group patients were significantly higher than low DHA group patients (P=0.005).Multivariate Cox proportional hazards model analysis found that cachexia (HR=4.973, 95% CI: 0.136-7.851, P=0.009), M1(HR=3.209, 95% CI: 1.113-4.386, P=0.023), low DHA level (HR=3.891, 95% CI: 0.360-8.25, P=0.021) were the significant risk factors of cancer-specific survival for renal cancer patients.In addition, there was no significant difference between preoperative DHA levels and postoperative DHA levels (P>0.05).Conclusions Preoperative DHA level can be used as an independent predictor of postoperative renal cancer patients.