早期肾透明细胞癌的高风险因素及预后分析

摘要

目的 探讨早期肾透明细胞癌的高危因素及与预后的关系. 方法 回顾性分析我院泌尿外科2010年12月至2017年12月间收治的105例pT1 N0 M0 期肾透明细胞癌患者的临床病理资料,分析其手术方式和组织病理学特征与临床预后的关系.预后的单因素分析采用 Kaplan‐Meier生存分析法,应用 Log‐rank检验各组差异.多因素分析使用Cox比例回归风险模型. 结果 105例患者术后1 、3和5年肿瘤特异性生存率分别为99·04%、97·14% 和96·19%,无复发生存率分别为96·19%、93·33% 和89·52%. Cox回归分析结果表明,肿瘤 T分期、WHO／ISU P分级和病理类型是影响早期肾透明细胞癌患者预后的独立危险因素(P＜0·05). 结论 早期肾透明细胞癌的WHO／ISUP病理分级作为独立的预后指标作用优于肿瘤T分期.%Objective To investigate the risk factors and prognosis of early clear cell renal cell carcinoma (ccRCC)· Methods T he clinicopathological data of 105 patients with stage pT 1 N0 M0 ccRCC who admitted to our department from December 2010 to December 2017 were enrolled· T he relationship between surgical methods , histopathological characteristics and clinical prognosis was retrospectively analyzed· T he univariate analysis of prognosis was performed using Kaplan‐M eier survival analysis ,the Log‐rank test was used to gauge the difference between groups· T he multivari‐ate analysis of prognosis was performed using Cox proportional regression risk model· Results T he 1‐year ,3‐year and 5‐year tumor‐specific survival rates were 99·04%,97·14% and 96·19% re‐spectively ,and the recurrence free survival rates were 96·19%,93·33% and 89·52% respectively· Cox regression analysis showed that the tumor T stage ,W HO／ISU P grading and pathological type were independent risk factors affecting the prognosis of patients with early ccRCC ( P＜0·05 )· Conclusions W HO／ISUP grading system was a better independent prognostic indicator than tumor T stage for early ccRCC·