影响肾癌预后因素的Cox回归分析

目的探讨影响肾癌预后的因素。方法采用Kapplan—Meier法计算生存概率、logrank检验生存率差异及应用Cox模型将获得随访的71例肾细胞癌患者的性别、年龄、是否偶发、临床分期、病理分类、手术方式、有无免疫治疗等因素作为分析因子，计算生存率，分析预后影响因素。结果71例患者的1年生存率为94．1％，3年生存率为81．3％，5年生存率为63．6％。单因素分析筛选出8个对肾细胞癌预后有影响的因素，分别为是否为偶发癌、TNM分期、是否有淋巴结转移、是否有癌栓、是否行根治性肾切除术、有无肿瘤细胞坏死、术后是否行免疫治疗、肿瘤病理类型。Cox多因素分析提示TNM分期、是否为偶发癌、是否行根治性肾切除术、术后是否行免疫治疗为影响肾癌预后的独立因素。结论肾细胞癌患者预后与肿瘤的TNM分期、是否行肾癌根治术、是否为偶发癌、术后有无行免疫治疗有关，其中肿瘤的TNM分期为危险因子，后3个因素为保护因子。

Cox regression analysis of prognostic factors for renal cell carcinoma

Objective To study the independent prognosis factors of survival for renal cell carcinoma（RCC）. Methods Clinical data of 71 cases of RCC were reviewed retrospectively. The survival rates were calculated by Kapplan-Meier method,and Cox regression model was used to analyze the relationship between the influencing factors and the prognosis. The relevant factors included sex, age, incidental occurrence, hematuria, lumbago, position, clinical staging, pathological classification, the postoperative therapy, etc. Results The survival rate at 1, 3 and 5 year were 94.1%, 81.3% and 63.6%,respectively. Cox regression model showed that the independent predictive factors were TNM staging, radical nephrectomy, incidental occurrence and immunotherapy. Conclusions There are certain correlation between prognosis and TNM staging, radical prostatectomy, incidental occurrence and immunotherapy.