基于SEER数据库分析肾细胞癌患儿的临床特征和预后  

Characteristics and predictors of survival in pediatric and adolescent renal cell carcinoma:a population-based study

作　　者：武鹏 罗若谷 徐泉 赵静儒 赵鹏靓 Wu Peng;Luo Ruogu;Xu Quan;Zhao Jingru;Zhao Pengliang(Department of Pediatric Surgery,Northwest Women&Children's Hospital,Xi'an 710061,China)

机构地区：[1]西北妇女儿童医院小儿外科,西安710061

出　　处：《中华小儿外科杂志》2024年第10期879-883,共5页Chinese Journal of Pediatric Surgery

基　　金：西北妇女儿童医院院内科研项目(2018LQ02)。

摘　　要：目的基于美国国家癌症研究所监测、流行病学和最终结果(the Surveillance,Epidemiology and End Results;SEER)数据库,探讨儿童及青少年肾细胞癌临床特征及预后危险因素。方法回顾性分析SEER数据库中收录时间为2000年至2018年的251例肾细胞癌患儿的临床资料,将患儿性别、年龄、TNM分期、人种、肿瘤组织形态、SEER分期、手术情况纳入单因素分析,将单因素分析中有统计学意义的因素纳入Cox比例风险模型进行多因素回归分析。采用Kaplan-Meier生存曲线法分析肿瘤组织形态、SEER分期及手术情况对肾细胞癌患儿生存率的影响,使用log-rank检验进行比较。结果251例患儿中男122例,女129例;年龄≤13岁84例,年龄>13岁167例;TNM分期Ⅰ期占44.2%(111/251)、Ⅱ期占12.4%(31/251)、Ⅲ期占27.9%(70/251)和Ⅳ期占15.5%(39/251);白种人173例,黑种人59例,其他人种19例;SEER分期中局限性肿瘤145例,区域性肿瘤48例,远处转移性肿瘤37例,21例未报告淋巴结转移情况;118例患儿行根治性肾切除,71例患儿行保留肾单位手术,31例患儿行完整性肾切除术,另31例患儿未接受手术治疗。单因素分析结果显示,性别、人种、TNM分期、肿瘤组织形态、SEER分期、手术情况与患儿总体生存率有关,差异有统计学意义(均P<0.05)。多因素分析结果显示,人种(P=0.005)、SEER分期(P<0.001)及手术情况(P=0.046)是影响患儿预后的独立危险因素。Kaplan-Meier生存曲线显示,肾髓质癌患儿预后相比其他肿瘤类型最差,存在远处转移的患儿预后相比其他分期更差,接受手术治疗的患儿生存率比未接受手术的患儿好(均P<0.001)。结论儿童及青少年肾细胞癌的预后受性别、人种、TNM分期、肿瘤组织形态、SEER分期及手术情况的影响,人种、SEER分期及手术情况是影响患儿预后的独立危险因素。Objective To explore the clinical features and prognostic risk factors of renal cell carcinoma in children and adolescents based upon the database of National Cancer Institute Surveillance,Epidemiology and End Results(SEER).Methods From 2000 to 2018,the relevant clinical data were retrospectively reviewed for 251 children with renal cell carcinoma(RCC)from the SEER database.Gender,age,TNM stage,race,histological type,SEER stage and operative type were included for univariate analysis.The factors statistically significant in univariate analysis were included into Cox proportional risk model for multivariate regression analysis.The effects of histological type,SEER stage and operative type on survival rate were analyzed by Kaplan-Meier survival curve and compared by Log-rank test.ResultsThere were 122 boys and 129 girls.Eighty-four cases were aged≤13 years and 167 cases>13 years;TNM stageⅠaccounted for 44.2%(111/251),stageⅡ12.4%(31/251),stageⅢ27.9%(70/251)and stageⅣ15.5%(39/251);there were 173 cases of white,59 cases of black and 19 cases of other races;there were localized tumors in SEER stage(n=145),regional tumors(n=48)and distant metastatic tumors(n=37);lymph node metastasis were not reported(n=21);the procedures included radical nephrectomy(n=118),surgery of preservating renal unit(n=71),complete nephrectomy(n=31)and non-operation(n=31).Univariate analysis indicated that gender,race,TNM stage,histological type,SEER stage and operative type were associated with overall survival rate and the differences were statistically significant(all P<0.05).The results of multivariate analysis revealed that race(P=0.005),SEER stage(P<0.001)and type of surgery(P=0.046)were independent risk factors for prognosis.Kaplan-Meier survival curves revealed that medullary carcinoma had the worst prognosis as compared with the other tumor types;the prognosis of those with distant metastasis was worse than the other stages;survival rate of those operated was higher than those non-operated(all P<0.001).Conclusions The prognosi

关 键 词：癌 肾细胞 人种 预后 

分 类 号：R737.11[医药卫生—肿瘤]