肾透明细胞癌心源性死亡的危险影响因素分析  

Risk factors for cardiogenic death in clear cell renal cell

作　　者：张黄成昊 王进奎 杭宇 计凤鸣 夭志刚 武成闯[1] 李金荣[1] 郝子朋 王志伟 姚桂萍 严兵[1] Zhanghuang Chenghao;Wang Jinkui;Hang Yu;Ji Fengming;Yao Zhigang;Wu Chengchuang;Li Jinrong;Hao Zipeng;Wang Zhiwei;Yao Guiping;Yan Bing(Department of Urology,Kunming Children′s Hospital,Yunnan Provincial Key Research Laboratory of Pediatric Major Diseases,Yunnan Provincial Children′s Health and Disease Clinical Medical Research Center,Kunming 650103,China;Pediatric Research Institute of Children′s Hospital Affiliated to Chongqing Medical University,Chongqing 400015,China)

机构地区：[1]昆明市儿童医院泌尿外科,云南省小儿重大疾病重点研究实验室,云南省儿童健康与疾病临床医学研究中心,昆明650103 [2]重庆医科大学附属儿童医院儿科研究所,重庆400015

出　　处：《国际泌尿系统杂志》2024年第4期649-653,共5页International Journal of Urology and Nephrology

基　　金：云南省科技厅昆医联合专项-面上项目(202301AY070001-108);云南省教育厅科学研究基金(2023J0295);云南省儿童健康与疾病临床医学研究中心开放研究基金(2022-ETYY-YJ-03)。

摘　　要：目的分析肾透明细胞癌(ccRCC)患者发生心源性死亡的危险因素,为提高ccRCC患者的生存率提供一定依据。方法回顾性分析2004年1月至2018年12月期间SEER数据库中的60508例ccRCC患者的临床资料。根据是否发生心源性死亡将患者分为存活组(58426例)和死亡组(2082例),对比两组患者的性别、年龄、TNM分期、肿瘤长径、手术情况、放化疗等临床资料并进行单因素分析;将组间比较中差异有统计学意义的单因素代入多因素Cox回归分析模型中,筛选出ccRCC患者发生心源性死亡的独立危险因素,并通过Log-rank检验和Kaplan-Meier曲线进行分析验证。结果两组患者的年龄、种族、性别、婚姻状况、诊断年份、肿瘤分级、T分期、N分期、M分期、手术情况、化疗及放疗情况比较,差异均有统计学意义(均P<0.05)。单因素Cox回归分析显示年龄、性别、种族、婚姻情况、肿瘤长径、T分期、N分期和手术情况与ccRCC患者的心源性死亡风险有相关性(均P<0.05)。多因素Cox回归分析结果显示,年龄>60岁、男性、未婚和未手术是ccRCC患者心源性死亡的独立危险因素(均P<0.05)。Log-rank检验分析的结果和多因素Cox回归分析结果一致。结论年龄>60岁、男性、未婚和未手术是ccRCC患者发生心源性死亡的独立危险因素。医生在临床诊治时应根据患者的具体情况采取个体化用药,以降低患者心源性死亡的风险,提高患者生存率。Objective To analyze the risk factors of cardiac death in patients with clear cell renal cell carcinoma(ccRCC),and to provide a basis for improving the survival rate of ccRCC patients.Methods The clinical data of 60508 cases ccRCC patients in the SEER database between January 2004 and December 2018 were retrospectively analyzed.Patients were divided into survival group(58426 cases)and death group(2082 cases)according to whether cardiac death occurred.The clinical data of gender,age,TNM stage,tumor length,operation,radiotherapy and chemotherapy were compared between the two groups,and univariate analysis was performed.A multivariate Cox regression analysis model was used to compare the univariate factors with significant differences,and the independent risk factors of cardiac death in ccRCC patients were screened out,and the Log-rank test and Kaplan-Meier curve were used for analysis and verification.Results There were statistically significant differences in age,race,sex,marital status,year of diagnosis,tumor grade,T stage,N stage,M stage,operation,chemotherapy and radiotherapy between the two groups(all P<0.05).Univariate Cox regression analysis showed that age,gender,race,marital status,tumor diameter,T stage,N stage and surgery were associated with the risk of cardiac death in ccRCC patients.Significant factors in univariate Cox regression analysis were included in multivariate Cox regression analysis,and the results showed that age over 60 years old,male,unmarried and no surgery were independent risk factors for cardiac death in ccRCC patients(all P<0.05).Conclusions Age>60 years old,male,unmarried and no surgery are independent risk factors for cardiac death in ccRCC patients.Doctors should take individualized medication according to the specific conditions of patients in clinical diagnosis and treatment,so as to reduce the risk of cardiac death and improve the survival rate of patients.

关 键 词：癌 肾细胞 心源性死亡 SEER数据库 

分 类 号：R737.11[医药卫生—肿瘤]