肾上腺皮质癌患者行根治性切除术的预后研究

目的 分析探讨肾上腺皮质癌(adrenocortical carcinomas,ACC)患者行根治性切除术后的长期生存率及相关影响因素,为临床判别患者死亡风险增高因素提供参考。 方法 回顾分析金华市人民医院2005年1月-2010年1月期间经病理活检确认为ACC并行根治性肾上腺切除术的18例ACC患者临床资料,应用Cox比例风险模型行单因素分析,采用Kaplan-Meier法计算患者生存率,采用log-rank法进行生存率的比较,分析患者长期预后及影响预后的因素。 结果 本组患者的中位年龄为48岁(23~67岁)。18例患者的中位随访时间是75个月(3~165个月),患者的3年、5年及10年生存率分别为55.5%、44.4%和16.7%。中位生存时间为46个月(1~158个月)。单因素分析显示肿瘤浸润程度及淋巴结转移与长期预后有关(P=0.02、0.01);此外,患者的3年、5年及10年无瘤生存率分别为55.5%、33.3%和33.3%。单因素分析显示,肿瘤浸润程度及淋巴结转移亦与无瘤生存周期有关(P<0.01、P=0.03)。 结论 根治性切除术可为ACC提供治愈的机会,肿瘤浸润程度及淋巴结转移是影响ACC患者预后的重要因素。 

Prognosis and influencing factors of radical resection for patients with adrenocortical carcinoma

Objective To investigate the analysis of adrenocortical carcinoma (adrenocortical,carcinomas,ACC) patients underwent radical resection related influencing the postoperative long-term survival rate and the factors for clinical reference increased mortality risk discriminant factors. Methods A retrospective analysis of Jinhua People's Hospital from January,2005 to January,2010 in Zhejiang during the biopsy confirmed the clinical data of 18 ACC patients ACC parallel radical resection of the adrenal gland,analysis and application of Cox proportional hazard model for single factor,calculate the patient survival rate by Kaplan-Meier method,compared the survival rate by log-rank method,analysis of the long-term prognosis and effect of patients prognostic factors. Results The median age of the patients was 48 years (23-67 years).Eighteen patients were followed up for a median of 75 months (3-165 months),with a mean of 3,5-and 10 year survival rates of 55.5%,44.4%,and 16.7%,respectively.The median survival time was 46 months (1-158 months).Univariate analysis showed that the degree of tumor infiltration and lymph node metastasis (P=0.02,0.01) were related to the long-term prognosis,and the disease-free survival rates of the patients at 3,5 and 10 years were about 55.5%,33.3%,respectively.Single factor analysis showed that the degree of tumor infiltration and lymph node metastasis were also associated with tumor free survival (P<0.01,P=0.03). Conclusion Radical resection can provide an opportunity for ACC,and the degree of tumor infiltration and lymph node metastasis are important factors affecting the prognosis of patients with ACC.