pT_(1a)期肾癌的预后因素分析  

The prognosis of patients with pT_(1a) renal cell carcinoma

作　　者：王一[1] 刘晓强[1] 郭战军[1] 胡海龙[1] 刘雨[1] 吴长利[1] 孙光[1] 

机构地区：[1]天津医科大学第二医院泌尿外科天津市泌尿外科研究所天津市泌尿外科基础医学重点实验室,300211

出　　处：《现代泌尿生殖肿瘤杂志》2014年第3期134-136,共3页Journal of Contemporary Urologic and Reproductive Oncology

基　　金：国家临床重点专科基金资助项目

摘　　要：目的通过术中及术后病理学相关因素对pT1a期肾癌患者进行预后分析。方法对2002年1月至2007年12月期间的168例pT1a期肾癌患者进行分析。所有患者均行单一肾癌根治术或肾部分切除术。对术前一般资料、随访时间、手术方式、病理学参数(肿瘤体积、肿瘤位置、病理类型等)进行回顾性分析。结果患者平均年龄为(61.8±10.4)岁,平均随访时间为(29.9±11.2)个月,5年肿瘤特异生存率及5年无复发生存率分别为100%和88.1%。15例患者存在远处转移,但未发现局部复发。在单因素分析中,肿瘤坏死、微血管浸润及Fuhrman′s核分级对远处转移有显著影响。多因素分析表明肿瘤坏死及微血管浸润为独立的预后因素。结论微血管浸润及肿瘤坏死为pT1a期肾癌患者的预后因素。Objective We intended to identify the perioperative and pathologic prognostic fac- tors of patients with pT1a stage RCC. Methods A total of 168 patients who were diagnosed as pT1aN0 M0 RCC between January 2002 and December 2007 were included. Preoperative data as age, sex, body and the presence of symptoms, followed up duration, surgical methods, and pathological parameters （tumor size, tumor location, histologic type, Fuhrman＇s nuclear grade and the presence of microvascular invasion, hemorrhage and necrosis in the tumor） were retrospectively analyzed to i- dentify the prognostic factors of pT1a RCC. Results All the patients underwent radical （n= 119, 70.8%） or partial （n：49, 29.2%） nephrectomy by a single surgeon. The patientsr mean age was （61.8±10.4） years and the mean followed up duration was （29.9±11.2） months. The 5-year canc- er-specific survival rate and the 5-year recurrence-free survival rate were 100% and 88.1%, respectively. Fifteen patients （8. 93%） showed distant metastasis without local recurence. Fuhrmanrs grade （P=0.01, OR= 6.25）, microvascular invasion （P〈0.01, OR ： 35.09）, and tumor necrosis （P〈0.01, OR=9.00） had a significant impact on distant metastasis in the univariate analysis. The multivariate analysis subsequently suggested that microvascular invasion （P= 0.02, OR = 83.21） and tumor necrosis （P〈0.01, OR=234.41） be the independent prognostic factors. Conclusions Microvascular invasion and tumor necrosis are the prognostic factors for patients with pT1a RCC.

关 键 词：肾肿瘤 预后 分期 

分 类 号：R737.11[医药卫生—肿瘤]