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目的:探讨术前诊断为肾脏恶性肿瘤的中国患者中行肾部分切除术后良性病理结果的发生率及其预测因素。方法:回顾性研究2008年1月~2015年12月术前诊断为恶性肾肿瘤,并接受开放、机器人或腹腔镜肾部分切除术的2 087例患者的基本信息、影像学及术后病理等资料,对患者分别按性别、年龄、体质指数、肿瘤大小、分侧等进行分组,运用卡方检验、logistic回归分析等统计方法分析患者的性别、年龄、肿瘤大小等预测因素与术后良性结果发生率的关系。结果:2 087例患者中,男1 544例(74.0%),女543例(26.0%),发病年龄17~85岁,平均(51.3±11.6)岁。共有43例(2.0%)为良性。分组进行卡方检验后,得知性别分组的良性发生率差异有统计学意义(P<0.001),年龄、BMI和肿瘤大小分组差异有统计学意义(P<0.05)。分组进行logistic二元回归分析得知,年龄和性别与肿瘤良性发生率呈负相关,肿瘤大小与良性发生率呈正相关。结论:术前诊断为恶性肿瘤,行肾部分切除术后良性病理结果的发生率为2.0%,较国内外同类研究明显偏低。女性、低龄、肿瘤体积大者术后良性结果的概率较其他患者为大,是良性占位病变的独立预测因素。
Objective: To investigate the incidence and prognostic factors of benign pathological findings after partial nephrectomy in Chinese patients with preoperative diagnosis of renal malignancy. Methods: A retrospective review of the basic information, imaging and postoperative pathology of 2 087 patients with preoperative diagnosis of malignant renal tumors from January 2008 to December 2015 who underwent open, robotic or laparoscopic partial nephrectomy The patients were divided into groups according to sex, age, body mass index, tumor size, sub-side and so on. The chi-square test and logistic regression analysis were used to analyze the predictive factors such as sex, age, tumor size and postoperative benign outcome The incidence of the relationship. Results: Of 2,087 patients, 5454 (74.0%) were male and 543 (26.0%) were female, with a mean age of onset of (51.3 ± 11.6) years old ranging from 17 to 85 years. A total of 43 cases (2.0%) were benign. According to the chi-square test, we found that there was a significant difference in the benign rates of gender group (P <0.001), and the differences of age, BMI and tumor size were statistically significant (P <0.05). Logistic regression analysis showed that there was a negative correlation between age and sex and the benign tumor incidence, and the tumor size was positively correlated with the benign rate. Conclusion: The preoperative diagnosis of malignant tumors, the partial nephrectomy benign pathological results of the incidence of 2.0%, compared with similar studies at home and abroad was significantly lower. The probability of benign outcomes in women, young adults, and those with large tumors is greater than in other patients and is an independent predictor of benign space-occupying lesions.