摘要
目的探讨肿瘤内改变在局限性肾透明细胞癌术后预后中的作用。方法回顾性分析手术治疗的283例肾透明细胞癌患者的临床病理特征,包括性别、年龄、平均体质指数、肿瘤内出血、肿瘤内坏死、肿瘤内囊性变、肿瘤肉瘤样变、Fuhrman分级、T分期等,并对其进行随访,获取无瘤生存时间及癌症特异性生存时间,通过单因素及多因素分析,得出影响肾透明细胞癌预后的因素。结果单因素发现,年龄、平均体质指数、肿瘤内出血、肿瘤内坏死、肿瘤肉瘤样变、Fuhrman分级、T分期是影响无复发生存的预后因素,年龄、平均体质指数、瘤内坏死、肿瘤肉瘤样变、Fuhrman分级、T分期是影响癌症特异性生存的预后因素。多因素分析发现,年龄、平均体质指数、肿瘤内坏死、肿瘤肉瘤样变、Fuhrman分级、T分期是影响肾透明细胞癌患者无复发生存及癌症特异性生存的独立预后因子。结论对于接受手术治疗的局限性肾透明细胞癌患者,肿瘤内改变如坏死、肉瘤样变是影响预后的独立因素。
Objective To investigate the prognostic value of intratumoral changes,such as bleeding,necrosis,cystic degeneration and sarcomatoid change,in surgical treated localized clear cell renal cell carcinoma.Method 283 patients receiving partial or radical nephrectomy between Jan 2008 and Jan 2013 in our department were retrospectively revised.Data such as gender,age,BMI,intratumoral changes,Fuhrman grade and T stage were collected,follow ups were carried out to get the recurrence-free survival and cancer-specific survival.Univariate and multivariate analysis were used to recognize the prognostic factors.Result Univariate analysis revealed that,age,BMI,intratumoral hemorrhage,tumor necrosis,sarcomatoid change,Fuhrman Grade and T stage were prognostic factors for recurrence-free survival,meanwhile,age,BMI,tumor necrosis,sarcomatoid change,Fuhrman Grade and T stage prognostic are the factors for cancer-specific survival.Multivariate analysis revealed that,tumor necrosis,sarcomatoid change,as well as age,BMI,Fuhrman Grade and T stage were independent prognostic factors for recurrence-free survival and cancerspecific survival.Conclusion Intratumoral changes,such as tumor necrosis and sarcomatoid change are independent prognostic factors affecting recurrence-free survival and cancer-specific survival for surgical treated localized clear cell renal cell carcinoma.
作者
孙凤岭
滕竞飞
关亚伟
贾卓敏
高峰
李志辉
艾星
SUN Feng-ling TENG Jing-fei GUAN Ya-wei JIA Zhuo-min GAO Feng LI Zhi-hui AI Xing(Department of Urology, PLA Army General Hospital, Beijing 100700, China)
出处
《中国临床医生杂志》
2016年第12期55-60,共6页
Chinese Journal For Clinicians
关键词
肾透明细胞癌
坏死
肉瘤样变
预后
Clear cell renal cell carcinoma
Necrosis
Sarcomatoid changes
Prognostic
