转移性肾癌术前D-二聚体对靶向治疗的预测意义.PDFVIP

992 中国肿瘤临床2016年第43卷第22期 ChinJClinOncol2016.Vol.43.No.22 临床研究与应用 · · 转移性肾癌术前D-二聚体对靶向治疗的预测意义 李宏蕾 冯国伟 林瑞 张艳辉 姚欣 摘要 目的：回顾性分析减瘤性肾切除术（cytoreductivenephrectomy，CN）术前各项临床指标对于联合靶向治疗的转移性肾癌 （metastaticrenalcellcarcinoma，mRCC）患者预后的影响。方法：收集1996年1月至2015年6月40例天津医科大学肿瘤医院行CN 且术后1年内行靶向药物治疗mRCC患者的临床病理学资料，采用Kaplan-Meier法进行单因素分析，Cox回归模型进行多因素分 析。结果：单因素生存分析结果显示，碱性磷酸酶、血小板与淋巴细胞比值（plateletlymphocyteratio，PLR）、中性粒细胞与淋巴细 胞比值（neutrophillymphocyteratio，NLR）、D-二聚体、T分期、肿瘤转移器官数目、MSKCC危险模型评分均为影响患者总生存期 （overallsurvival,OS）的危险因素（P0.005），其中碱性磷酸酶、PLR、NLR、D-二聚体、肿瘤转移器官数目、MSKCC危险模型评分为 影响无进展生存期（progression-freesurvival,PFS）的危险因素（P0.005）。Cox回归模型多因素分析结果显示，D-二聚体（P= 0.033）是影响患者OS、PFS的独立因素，同时碱性磷酸酶（P=0.045）、MSKCC危险模型评分（P=0.003）也是影响PFS的独立因素。 结论：术前D-二聚体水平是行CN联合靶向治疗mRCC患者的独立预后危险因素。 关键词 减瘤性肾切除术 转移性肾癌 预后 D-二聚体 靶向治疗 doi:10.3969/j.issn.1000-8179.2016.22.025 Prognostic value of preoperative D- dimer in metastatic renal cell carcinoma patients with targeted therapy Honglei LI, Guowei FENG, Rui LIN, Yanhui ZHANG, Xin YAO Correspondence to: Xin YAO; E-mail: yaoxin1969@ Department of Genitourinary Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjins Clinical Research Center for Cancer, Tianjin 300060, China Abstract Objective: To evaluate cytoreductive nephrectomy pre-operative variables for examining their prognostic value in metastat- ic renal cell carcinoma (mRCC) patients with targeted therapy. Methods: This retrospective study reviewed the clinicopathological data of 40 patients who underwent cytoreductive nephrectomy surgery followed by targeted therapy within one year in Tianjin Medical Uni- versity Cancer Institute and Hospital between January 1996 and June 2015. Kaplan-Meier method was adopted for single factor analy- sis, and Cox regression model was used for multivariate analysis. Res