术前前白蛋白与肾透明细胞癌患者预后的关系  

Relationship of preoperative prealbumin and prognosis of patients with clear cell renal cell carcinoma

作　　者：吴荣祖 陈真[1] 庄乾锋[1] 范敏[1] 许贤林[1] 

机构地区：[1]常州市第一人民医院泌尿外科,江苏213003

出　　处：《江苏医药》2018年第1期39-42,共4页Jiangsu Medical Journal

基　　金：江苏省自然科学基金青年基金(BK20150251);江苏省青年医学人才项目(QNRC2016292)

摘　　要：目的探讨术前前白蛋白水平与肾透明细胞癌患者预后的关系。方法回顾性分析414例经术后病理证实为肾透明细胞癌患者的临床资料。采用受试者工作特征曲线确定前白蛋白的最佳临界值为250mg/L,根据临界值将患者分为高前白蛋白组(267例)和低前白蛋白组(147例)。采用Kaplan-Meier法计算总生存率,Log-rank检验比较两组间的生存率差异。采用单因素和多因素分析法分析影响肾透明细胞癌患者的预后因素。结果两组年龄、性别构成比、TNM分期、Fuhrman分级、肿瘤坏死及脉管侵犯比例差异有统计学意义(P<0.05或P<0.01)。单因素生存分析结果显示,年龄、TNM分期、Fuhrman分级、肿瘤坏死、脉管侵犯和前白蛋白是影响肾透明细胞癌的预后因素(P<0.05或P<0.01)。Cox多因素分析结果显示,前白蛋白[HR=2.774,95%CI(1.395~5.513),P<0.01]、年龄(P<0.05)和TNM分期(P<0.01)是影响肾透明细胞癌的独立预后因素。结论术前前白蛋白水平是肾透明细胞癌患者的独立预后因素。Ojective To explore the relationship between preoperative prealbumin（PA）level and the prognosis of the patients with clear cell renal cell carcinoma（ccRCC）.Methods The clinicopathological data of 414 ccRCC cases confirmed by postoperative pathologic diagnosis were analyzed,retrospectively.The optimal cutoff value（250 mg/L）for PA was determined using receiver operating characteristic curve analysis,based on which the patients were divided into high PA group（267 cases）and low PA group（147 cases）.The overall survival rate was estimated using KaplanMeier method and compared using the Log-rank test between two groups.Univariate analysis was performed in age,gender,TNM classification,Fuhrman classification,tumor necrosis,vasculature invasion and PA.Multivariate model was used to analyze the association of PA with clinicopathologic outcome.Results The differences in age,gender,TNM classification,Fuhrman classification,tumor necrosis,vasculature invasion were statistically significant between two groups（P〈0.05 or P〈0.01）.Univariate analysis showed that the age,TNM classification,Fuhrman classification,tumor necrosis and vasculature invasion were the factors to predict the prognosis of ccRCC patients（P〈0.05 or P〈0.01）.Cox multifactor analysis revealed that the PA [HR=2.774,95% CI（1.395-5.513）,P〈0.01],age（P〈0.05）and TNM classification（P〈0.01）were the independent prognostic factors of patients with ccRCC.Conclusion The preoperative PA level is an independent prognosis factor of patients with ccRCC.

关 键 词：肾透明细胞癌 前白蛋白 预后 

分 类 号：R737[医药卫生—肿瘤]