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中国多中心回顾性研究:儿童与成人 Xp11 易位性肾细胞癌的临床病理特征与结局比较。

Comparative Clinicopathologic Characteristics and Outcomes of Paediatric and Adult Xp11 Translocation Renal Cell Carcinomas: a Retrospective Multicentre Study in China.

机构信息

Department of Urology, Drum Tower Clinical Medical School of Nanjing Medical University, Nanjing, Jiangsu, China.

Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China.

出版信息

Sci Rep. 2020 Feb 10;10(1):2249. doi: 10.1038/s41598-020-59162-5.

Abstract

This study aimed to compare the clinicopathologic features and prognosis in patients with Xp11 translocation renal cell carcinomas (RCCs). In total, 8083 RCCs were screened at five centres from January 2007 to December 2018, including 8001 adults (≥18 years) and 82 children (<18 years). Finally, 73 adults and 17 children were identified as Xp11 translocation RCCs, accounting for 1.1% (90 of 8083) of the RCCs. However, 4 children and 1 adult were excluded because of loss to follow-up when performing the survival analysis. The proportion of paediatric and adult Xp11 translocation RCCs was 20.7% (17 of 82) and 0.9% (73 of 8001) of RCCs, respectively, and the incidence in children and adults was significantly different (P < 0.01). Lymph node positivity (LN+) most commonly occurred in children (58.8%) compared with adults (28.8%; P = 0.02), but children with LN+ showed significantly higher five-year overall survival and progression-free rates (OS: 75.0%; PFS: 64.8%) than adult patients (OS: 40.3%; PFS: 0%) (log-rank P < 0.01; P = 0.04). Multivariable analysis indicated that local lymph node metastasis was associated with both PFS (HR = 0.10; 95% CI 0.02-0.51; P = 0.01) and OS (HR = 0.11; 95% CI 0.01-0.98; P = 0.04) in adults. Adult patients with LN+ may indicate a worse prognosis than paediatric patients.

摘要

本研究旨在比较 Xp11 易位肾细胞癌(RCC)患者的临床病理特征和预后。在五个中心,从 2007 年 1 月至 2018 年 12 月共筛选了 8083 例 RCC,包括 8001 例成人(≥18 岁)和 82 例儿童(<18 岁)。最终,有 73 例成人和 17 例儿童被确定为 Xp11 易位 RCC,占所有 RCC 的 1.1%(90/8083)。然而,在进行生存分析时,由于失访,有 4 例儿童和 1 例成人被排除在外。儿童和成人 Xp11 易位 RCC 的比例分别为 20.7%(17/82)和 0.9%(73/8001),儿童和成人的发病率差异有统计学意义(P<0.01)。与成人(28.8%)相比,淋巴结阳性(LN+)在儿童中更为常见(58.8%)(P=0.02),但 LN+的儿童患者五年总生存率和无进展生存率显著高于成人患者(OS:75.0%;PFS:64.8%)比成人患者(OS:40.3%;PFS:0%)(对数秩 P<0.01;P=0.04)。多变量分析表明,局部淋巴结转移与成人的 PFS(HR=0.10;95%CI 0.02-0.51;P=0.01)和 OS(HR=0.11;95%CI 0.01-0.98;P=0.04)相关。有淋巴结转移的成年患者的预后可能比儿童患者差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c697/7010786/70c862c9f782/41598_2020_59162_Fig1_HTML.jpg

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