肾血管平滑肌脂肪瘤自然病程及其进展的危险因素分析  

Natural course of renal angiomyolipoma and risk factors for its progression

作　　者：缪忠清 杜冬[2] 林泽裕 杜齐志 薛菡 罗春梅 肖克峰[3] 江洪涛[3] Miao Zhongqing;Du Dong;Lin Zeyu;Du Qizhi;Xue Han;Luo Chunmei;Xiao Kefeng;Jiang Hongtao(The Second Clinical Medical College of Jinan University,Shenzhen 518020,China;Department of Health Management,The First Affiliated Hospital of Southern University of Science and Technology,Shenzhen People’s Hospital,The Second Clinical Medical College of Jinan University,Shenzhen 518020,China;Department of Urology,The First Affiliated Hospital of Southern University of Science and Technology,Shenzhen People’s Hospital,The Second Clinical Medical College of Jinan University,Shenzhen 518020,China)

机构地区：[1]暨南大学第二临床医学院,深圳518020 [2]暨南大学第二临床医学院、深圳市人民医院、南方科技大学第一附属医院健康管理科,深圳518020 [3]暨南大学第二临床医学院、深圳市人民医院、南方科技大学第一附属医院泌尿外科,深圳518020

出　　处：《中华泌尿外科杂志》2025年第3期192-197,共6页Chinese Journal of Urology

摘　　要：目的探讨肾血管平滑肌脂肪瘤的自然病程及其进展的危险因素。方法本研究为回顾性病例对照研究。检索深圳市人民医院体检系统2012年1月至2024年6月经体检超声多次诊断为肾血管平滑肌脂肪瘤的患者,共纳入401例,所有患者均未治疗。男128例(31.90%),女273例(68.10%);初诊年龄(44.04±10.24)岁(22~78岁);初诊肿瘤中位最大径为9.0(7.0,11.5)mm;单发肿瘤359例(89.50%),多发肿瘤42例(10.50%)。依据肿瘤随访期间年平均增长速率分为非进展组(<1 mm/年)和进展组(≥1 mm/年)。比较两组患者性别、初诊年龄以及初诊肿瘤大小、数量、部位、单双侧等的差异。采用单因素logistic回归分析上述因素与肾血管平滑肌脂肪瘤进展的关系,采用多因素logistic回归分析其进展的危险因素。结果401例随访时间(88.15±21.09)个月(48~140个月)。末次随访时肿瘤中位最大径为11.0(8.0,14.0)mm;平均增长速率为0.38 mm/年,中位增长速率为0.25(0,0.60)mm/年。非进展组341例(85.04%),平均增长速率0.14 mm/年;进展组60例(14.96%),平均增长速率1.74 mm/年。进展组年龄低于非进展组[(41.43±9.64)岁与(44.50±10.29)岁],肿瘤初始最大径大于非进展组[11.0(8.0,16.0)mm与9.0(7.0,11.0)mm],多发肿瘤比例高于非进展组[14例(23.30%)与28例(8.20%)],差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,初诊年龄(OR=0.96,95%CI 0.93~0.99)、肿瘤初始最大径(OR=1.08,95%CI 1.04~1.12)和数量(OR=2.96,95%CI 1.38~6.34)是肾血管平滑肌脂肪瘤进展的危险因素(P<0.05)。结论多数肾血管平滑肌脂肪瘤的自然病程表现为缓慢增长或相对静止,少部分有明显增长趋势,患者年龄、初始肿瘤大小和数量是肾血管平滑肌脂肪瘤进展的独立危险因素。ObjectiveTo clarify the natural course of renal angiomyolipoma and the risk factors for its progression.MethodsThis was a retrospective case-control study that included 401 patients diagnosed several times by ultrasound examination in the hospital physical examination system from January 2012 to June 2024.All patients were untreated.There were 128 male cases(31.90%)and 273 female cases(68.10%).The average age at initial diagnosis was(44.04±10.24)years(range 22-78 years).The median longest diameter of the tumor at initial diagnosis was 9.0(7.0,11.5)mm.There were 359 cases(89.50%)with single tumors and 42 cases(10.50%)with multiple tumors.The patients were divided into the progression group(≥1 mm/year)and the non-progression group(<1 mm/year)based on the average growth rate of tumor.The differences in gender,age at initial diagnosis,initial tumor size,number of lesions and lesion site between the two groups were compared.Univariate logistic regression analysis was used to explore the relationship between the above factors and the progression of renal angiomyolipoma.Multivariate logistic regression analysis was conducted to identify the risk factors for progression.ResultsA total of 401 cases were followed up for an average of(88.15±21.09)months(range 48-140 months).The median maximum diameter of the tumors at the initial diagnosis was 9.0(7.0,11.5)mm,and at the end of the follow-up,it was 11(8,14)mm.The average growth rate was 0.38 mm/year,and the median growth rate was 0.25(0,0.60)mm/year.Among them,341 cases(85.04%)were in the non-progression group with an average growth rate of 0.14 mm/year,and 60 cases(14.96%)were in the progression group with an average growth rate of 1.74 mm/year.The age of the progression group was lower than that of the non-progression group[(41.43±9.64)years vs.(44.50±10.29)years],the initial maximum diameter of the tumors in the progression group was larger than that in the non-progression group[11.0(8.0,16.0)mm vs.9.0(7.0,11.0)mm],and the proportion of multiple tumors in the progre

关 键 词：肾肿瘤 血管平滑肌脂肪瘤 自然病程 危险因素 

分 类 号：R737.11[医药卫生—肿瘤]