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目的:探讨T1a期肾肿瘤患者肾部分切除术后良性组织学结果的相关预测因素。方法:回顾性分析2010年1月~2014年10月于青岛大学附属医院接受肾部分切除术的140例T1a期肾肿瘤患者的临床及影像学资料,并行R.E.N.A.L解剖学评分,比较年龄、性别、体质指数(BMI)、肿瘤侧别、临床症状、R.E.N.A.L评分等因素在术后良恶性病理结果中的差异,应用Logistic回归分析模型探讨相关因素与T1a期肾肿瘤良性组织学结果的关系。结果:140例患者中,良性病变12例(8.6%),其中7例(58.3%)为男性,5例(41.7%)为女性。良性病变患者平均年龄及BMI均明显小于恶性病变患者,解剖学因素中仅E评分在良恶性之间的差异有统计学意义(P<0.05)。Logistic回归分析显示年龄(OR=1.155;95%CI:1.041~1.281;P=0.006)、BMI(OR=1.509;95%CI:1.118~2.037;P=0.007)以及E=1分(OR=0.017;95%CI:0.001~0.585;P=0.024)是术后良性组织学结果的独立预测因素。结论:本研究结果表明,年龄、BMI及肿瘤外生型生长是T1a期肾肿瘤术后良性组织学结果的独立预测因素。
Objective: To investigate the related predictors of benign histologic findings after partial nephrectomy in patients with stage T1a renal tumors. Methods: The clinical and imaging data of 140 patients with stage T1a renal cell carcinoma who underwent partial nephrectomy at Qingdao University Affiliated Hospital from January 2010 to October 2014 were retrospectively analyzed. The RENAL anatomical score was compared with the age, sex, BMI, tumor side, clinical symptoms, RENAL score and other factors in benign and malignant pathological results of postoperative differences, the use of Logistic regression model to explore the relationship between factors and T1a stage renal neoplasms benign histological results. RESULTS: Of the 140 patients, benign lesions were found in 12 (8.6%), 7 (58.3%) were male and 5 (41.7%) were women. The mean age and BMI of patients with benign lesions were significantly lower than those of malignant lesions. There was statistically significant difference between the benign and malignant lesions (P <0.05). Logistic regression analysis showed that age (OR = 1.155; 95% CI: 1.041-1.281; P = 0.006), BMI (OR = 1.509; 95% CI: 1.118-2.037; ; 95% CI: 0.001-0.585; P = 0.024) were independent predictors of postoperative benign histologic outcome. CONCLUSIONS: The results of this study suggest that age, BMI, and tumor growth are independent predictors of postoperative histologic postoperative T1a tumors.