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目的阐明上海市杨浦区2002-2012年间肾细胞癌(renal cell carcinoma,RCC)发病率和死亡率。方法整理上海市肿瘤登记报告系统中的杨浦区户籍人群RCC病例资料,应用年均变化百分比(APC)模型分析患者发病的时间趋势,应用Kaplan-Meier模型并结合Log-rank检验进行生存分析。采用2000年全国人口普查的标准人口年龄构成进行标化。结果 2002-2012年间RCC新发患者1 092例,占同期全区新发恶性肿瘤的2.34%。RCC年均粗发病率为9.16/105,标化发病率为5.12/105。男性发病率高于女性(粗发病率11.79/105 vs 6.41/105,P<0.01;标化发病率6.54/105 vs 3.61/105,P<0.01)。男性50岁,女性55岁以后RCC发病率迅速增加。2002-2012年间男性粗发病率逐年增长(APC=10.45),女性粗发病率也明显增长(APC=6.37)。因RCC死亡369例,年均粗死亡率为3.10/105,标化死亡率为1.33/105。40岁以上男性、55岁以上女性死亡率明显上升。男性5年生存率高于女性(71.80%vs 69.77%,P>0.01)。手术治疗组5年生存率高于非手术组(87.75%vs 53.69%,P<0.01)。结论年龄和性别是影响RCC发病率差异的主要因素,RCC死亡率低于发病率,手术治疗可有效提高RCC患者生存期。
Objective To clarify the incidence and mortality of renal cell carcinoma (RCC) in Yangpu district of Shanghai from 2002 to 2012. Methods The data of RCC cases in Yangpu district from Shanghai Tumor Registry and Reporting System were collected. The time trend of the incidence of RCC cases was analyzed by APC model. Kaplan-Meier model and Log-rank test were used for survival analysis. The standard population age composition of the 2000 national census is used for standardization. Results A total of 1092 new cases of RCC were found in 2002-2012, accounting for 2.34% of the newly diagnosed malignant tumors in the same period. RCC average annual incidence of 9.16 / 105, the standardized incidence rate of 5.12 / 105. The incidence of males was higher than that of females (crude incidence 11.79 / 105 vs 6.41 / 105, P <0.01; standardized incidence 6.54 / 105 vs 3.61 / 105, P <0.01). Male 50 years old, female 55 years old RCC incidence increased rapidly. The crude incidence of males increased from 2002 to 2012 (APC = 10.45), and the incidence of crude females also increased significantly (APC = 6.37). 369 deaths due to RCC, with an average annual crude death rate of 3.10 / 105 and a standardized mortality rate of 1.33 / 105. Men over the age of 40, the mortality rate of women over the age of 55 increased significantly. Male 5-year survival rate was higher than female (71.80% vs 69.77%, P> 0.01). The 5-year survival rate of surgical treatment group was higher than that of non-operation group (87.75% vs 53.69%, P <0.01). Conclusion Age and gender are the major factors affecting the incidence of RCC. The mortality of RCC is lower than the incidence. Surgical treatment can effectively improve the survival of patients with RCC.