中华临床医师杂志(电子版)
中華臨床醫師雜誌(電子版)
중화림상의사잡지(전자판)
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
4期
638-642
,共5页
马清昌%李延江%赵振威%刘松林%仝义锐%王亮
馬清昌%李延江%趙振威%劉鬆林%仝義銳%王亮
마청창%리연강%조진위%류송림%동의예%왕량
癌,肾细胞%腺癌,透明细胞%血小板增多%生存率%预后
癌,腎細胞%腺癌,透明細胞%血小闆增多%生存率%預後
암,신세포%선암,투명세포%혈소판증다%생존솔%예후
Carcinoma,renal cell%Adenocarcinoma,clear cell%Thrombocytosis%Survival%Prognosis
目的:探讨术前外周血血小板计数对肾透明细胞癌(CCRCC)预后的意义。方法回顾性分析初诊并术后病理证实的292例CCRCC患者的临床资料及随访情况,以患者血小板计数300×109/L为界值将患者分为正常和增高两组,应用Kaplan-Meier法进行生存分析并行Log-rank检验, Cox 比例风险模型分析血小板增高及其他临床因素对患者总生存(OS)和无进展生存(PFS)预后的影响。结果该研究CCRCC患者中血小板增高发生率为9.59%(28/292),正常组1年、3年、5年的总生存率和无进展生存率分别为100%、99%、97%和99%、97%、86%,而增高组分别为89%、84%、84%和86%、81%、81%,两组OS(χ2=13.023,P=0.000)和PFS(χ2=3.968,P=0.046)比较有统计学意义。单因素分析显示,发病方式、肿瘤大小、肿瘤坏死情况、病理分级、T 分期、TNM分期是OS的预后因素,而且肿瘤大小和TNM分期还是PFS的预后因素。多因素分析显示,病理T分期和TNM分期是PFS预后的独立因素,血小板计数是OS预后的独立因素。结论术前外周血血小板增高是CCRCC预后不良的独立预后因素。
目的:探討術前外週血血小闆計數對腎透明細胞癌(CCRCC)預後的意義。方法迴顧性分析初診併術後病理證實的292例CCRCC患者的臨床資料及隨訪情況,以患者血小闆計數300×109/L為界值將患者分為正常和增高兩組,應用Kaplan-Meier法進行生存分析併行Log-rank檢驗, Cox 比例風險模型分析血小闆增高及其他臨床因素對患者總生存(OS)和無進展生存(PFS)預後的影響。結果該研究CCRCC患者中血小闆增高髮生率為9.59%(28/292),正常組1年、3年、5年的總生存率和無進展生存率分彆為100%、99%、97%和99%、97%、86%,而增高組分彆為89%、84%、84%和86%、81%、81%,兩組OS(χ2=13.023,P=0.000)和PFS(χ2=3.968,P=0.046)比較有統計學意義。單因素分析顯示,髮病方式、腫瘤大小、腫瘤壞死情況、病理分級、T 分期、TNM分期是OS的預後因素,而且腫瘤大小和TNM分期還是PFS的預後因素。多因素分析顯示,病理T分期和TNM分期是PFS預後的獨立因素,血小闆計數是OS預後的獨立因素。結論術前外週血血小闆增高是CCRCC預後不良的獨立預後因素。
목적:탐토술전외주혈혈소판계수대신투명세포암(CCRCC)예후적의의。방법회고성분석초진병술후병리증실적292례CCRCC환자적림상자료급수방정황,이환자혈소판계수300×109/L위계치장환자분위정상화증고량조,응용Kaplan-Meier법진행생존분석병행Log-rank검험, Cox 비례풍험모형분석혈소판증고급기타림상인소대환자총생존(OS)화무진전생존(PFS)예후적영향。결과해연구CCRCC환자중혈소판증고발생솔위9.59%(28/292),정상조1년、3년、5년적총생존솔화무진전생존솔분별위100%、99%、97%화99%、97%、86%,이증고조분별위89%、84%、84%화86%、81%、81%,량조OS(χ2=13.023,P=0.000)화PFS(χ2=3.968,P=0.046)비교유통계학의의。단인소분석현시,발병방식、종류대소、종류배사정황、병리분급、T 분기、TNM분기시OS적예후인소,이차종류대소화TNM분기환시PFS적예후인소。다인소분석현시,병리T분기화TNM분기시PFS예후적독립인소,혈소판계수시OS예후적독립인소。결론술전외주혈혈소판증고시CCRCC예후불량적독립예후인소。
Objective To evaluate the prognostic significance of the preoperative elevated platelet count in patients with clear cell renal cell carcinoma (CCRCC). Methods The clinical data of 292 CCRCC patients, firstly diagnosed and confirmed by postoperative tissue diagnosis, was analyzed retrospectively and all of them were followed-up. The 292 patients were divided into normal and elevated groups by the value of platelet count (300×109/L). Kaplan-Meier and Log-Rank test were used to analyze the data. Prognostic factors of over survival (OS)and progression free survival (PFS) in these patients were analyzed by Cox proportional hazards model. Results 1 year, 3 years, 5 years overall survival rates and progression free survival rates were 100%, 99%, 97%and 99%, 97%, 86%in normal group and 89%, 84%, 84%and 86%, 81%, 81%in elevated group, respectively. OS(χ2=13.023, P=0.000) and PFS(χ2=3.968, P=0.046) between two group were statistically different.Univariate analysis showed that patients diagnosed with or without kidney triad, tumor size, tumor necrosis, pathological grade, T stage, TNM stage were prognostic factors of the OS in CCRCC patients and tumor size and TNM stage were also prognostic indicator of the PFS. Multivariate analysis showed that T stage and TNM stage were independent prognostic factors of the PFS for CCRCC and preoperative platelet count was an independent prognostic predictor of the OS. Conclusion The preoperative thrombocytosis is an independent poor prognostic factor for CCRCC.