新疆乌鲁木齐市双中心233例晚期肾细胞癌患者的预后分析  

Prognosis of 233 advanced renal cell carcinoma patients in Urumqi:a two-center study

作　　者：地里亚尔·地里夏提 袁帅[2] 鲁剑德 乔炳璋 王文光[1] 陈鹏[2] 木拉提·热夏提[1] 拜合提亚·阿扎提[1] DILIYAER Dilixiati;YUAN Shuai;LU Jiande;QIAO Bingzhang;WANG Wenguang;CHEN Peng;MULATI Rexiati;BAIHETIYA Azhati(Department of Urology,The First Affiliated Hospital of Xinjiang Medical University,Xinjiang Clinical Medical Research Center of Urogenital Diseases;Department of Urology,The Affiliated Cancer Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院泌尿中心,新疆泌尿男生殖系疾病临床医学研究中心 [2]新疆医科大学附属肿瘤医院泌尿外科,乌鲁木齐830054

出　　处：《现代泌尿外科杂志》2024年第4期306-311,共6页Journal of Modern Urology

基　　金：新疆医科大学2023年18期大学生创新创业训练计划项目(No.X202310760124)。

摘　　要：目的探讨新疆地区晚期肾细胞癌患者的临床特点、治疗方法及预后情况,并对其中汉族患者的临床特点及预后情况行进一步分析。方法回顾性分析2012年1月—2020年1月新疆医科大学第一附属医院、附属肿瘤医院泌尿中心收治的233例晚期肾癌患者的临床资料,中位年龄52(23~87)岁,肿瘤最大径(7.73±4.04)cm,其中汉族患者133例。使用Kaplan-Meier法绘制生存曲线,对所有患者行单因素、多因素Cox回归分析,并对汉族患者进行进一步分析。结果233例晚期肾癌患者中131例死亡,术后平均随访27.6(1~120)个月,中位生存时间12个月。本组晚期肾癌患者淋巴结转移110例,远处转移200例,其中脑转移21例(10.5%)、肾上腺转移45例(22.5%)。本组晚期肾癌患者1、3、5年生存率分别是48.9%、18.3%、6.1%,单因素分析结果显示,国际转移性肾细胞癌数据库联盟危险分层(IMDC)评分、病理类型、淋巴结转移、远处转移、转移灶数量、治疗方式是影响新疆地区晚期肾癌患者预后的因素(P<0.05);多因素分析结果显示,IMDC评分、病理类型、远处转移是影响新疆地区晚期肾癌患者预后的因素(P<0.05)。汉族亚组患者的多因素分析结果,IMDC评分、病理类型和远处转移是影响新疆地区汉族晚期肾癌患者预后的因素(P<0.05)。结论新疆地区晚期肾癌患者5年生存率为6.1%,中位生存时间12个月,脑转移、肾上腺转移率较高。IMDC评分、病理类型、远处转移是影响新疆地区晚期肾癌患者及新疆地区汉族晚期肾癌患者预后的因素。Objective To investigate the clinical features,treatment methods and prognosis of advanced renal cell carcinoma(RCC)patients in Xinjiang,especially the Han population.Methods Clinical data of 233 patients with advanced RCC treated in The First Affiliated Hospital and The Affiliated Cancer Hospital of Xinjiang Medical University were retrospectively analyzed,including 133 Han patients.The median age of patients was 52 years(range:23 to 87),and the maximum tumor diameter was(7.73±4.04)cm.Survival curves were plotted using the Kaplan-Meier method.Multivariate and univariate Cox regression analysis were conducted for all patients,and further analysis was performed for the Han patients.Results Among the 233 patients,131 died during the average follow-up of 27.6 months(range:1 to 120),and the median survival time was 12 months.In this cohort,110 patients had lymph node metastasis,and 200 had distant metastasis,among them,21(10.5%)patients had brain metastasis and 45(22.5%)patients had adrenal metastasis.The 1-,3-,and 5-year survival rate were 48.9%,18.3%and 6.1%,respectively.Univariate analysis revealed that International mRCC Database Consortium(IMDC)score,pathological type,lymph node metastasis,distant metastasis,number of metastatic foci and treatment methods impacted the prognosis in Xinjian(P<0.05).Multivariate analysis indicated that IMDC score,pathological type and distant metastasis were significant factors influencing the prognosis,which were also the prognostic factors of the Han patients(P<0.05).Conclusion In Xinjiang,patients with advanced renal cell carcinoma have a 6.1%5-year survival rate and a median survival time of 12 months.Brain and adrenal metastases are common.Prognostic factors include IMDC score,pathological type,and distant metastasis for all patients,including the Han patients.

关 键 词：肾细胞癌 远处转移性 临床病理特征 国际转移性肾细胞癌数据库联盟危险分层 新疆地区 

分 类 号：R737.11[医药卫生—肿瘤]