Zuo M N, DU Y Q, Yu L P, Dai X, Xu T
Department of Urology, Peking University People's Hospital, Beijing 100044, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2022 Aug 18;54(4):636-643. doi: 10.19723/j.issn.1671-167X.2022.04.009.
To investigate the effects of MetS on the prognosis of patients with clear cell renal cell carcinoma (ccRCC).
Clinical and pathological data and the laboratory test of ccRCC 342 patients with diverticular stones who underwent ccRCC who underwent radical or partial nephrectomy were retrospectively collected and analyzed.The patients were divided into MetS group and non-MetS group, and the subgroups were defined according to the tumor size. The overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS) of the two groups were analyzed by univariate Cox analysis, and the subgroup analyses were also performed. Kaplan-Meier survival curve and survival analysis for OS, CSS, and PFS of the two groups and the subgroups were conducted.
Univariate Cox analysis showed that MetS was a protective factor of postoperative OS [hazard ratio ()=0.551, 95%: 0.321-0.949, =0.031], CSS (=0.460, 95%: 0.234-0.905, =0.025), and PFS (HR 0.585, 95%: 0.343-0.998, =0.049) in the patients with ccRCC. In the subgroup with tumor size≤4 cm, MetS was not associated with postoperative OS (=0.857, 95%: 0.389-1.890, =0.702), CSS (=1.129, 95%: 0.364-3.502, =0.833), and PFS (=1.554, 95%: 0.625-3.864, =0.343). In the subgroup with tumor size>4 cm, Mets was a protective factor of postoperative OS (HR=0.377, 95%: 0.175-0.812, 0.013), CSS (=0.280, 95%: 0.113-0.690, =0.006), and PFS (=0.332, 95%: 0.157-0.659, =0.002); Obesity was a protective factor of postoperative CSS (=0.464, 95%: 0.219-0.981, =0.044), and PFS (=0.445, 95%: 0.238-0.833, =0.011). Kaplan-Meier survival analysis showed that the long-term survival of patients with MetS was better than those without MetS in OS (=0.029), CSS (=0.021), and PFS (0.046); for the subgroup with tumor size≤4 cm, there was no significant difference in postoperative OS (=0.702), CSS (=0.833), and PFS (=0.339) between patients with and without MetS; For the subgroup with tumor size>4 cm, the OS (=0.010), CSS (0.003), and PFS (=0.001) of patients with MetS were better than those without MetS.
MetS was a protective factor of postoperative OS, CSS, and PFS in the patients with ccRCC, which was more obvious in subgroup with tumor size>4 cm. And obesity, the component of MetS, was correlated with postoperative OS and CSS.
探讨代谢综合征（MetS）对肾透明细胞癌（ccRCC）患者预后的影响。
回顾性收集并分析342例行根治性或部分肾切除术的ccRCC合并憩室结石患者的临床病理资料及实验室检查结果。将患者分为MetS组和非MetS组，并根据肿瘤大小进行亚组划分。采用单因素Cox分析两组的总生存期（OS）、癌症特异性生存期（CSS）和无进展生存期（PFS），并进行亚组分析。绘制两组及亚组的Kaplan-Meier生存曲线并进行OS、CSS和PFS的生存分析。
单因素Cox分析显示，MetS是ccRCC患者术后OS的保护因素[风险比（HR）=0.551，95%可信区间（CI）：0.321-0.949，P=0.031]、CSS（HR=0.460，95%CI：0.234-0.905，P=0.025）和PFS（HR=0.585，95%CI：0.343-0.998，P=0.049）。在肿瘤大小≤4 cm的亚组中，MetS与术后OS（P=0.857，95%CI：0.389-1.890，P=0.702）、CSS（P=1.129，95%CI：0.364-3.502，P=0.833）和PFS（P=1.554，95%CI：0.625-3.864，P=0.343）均无关。在肿瘤大小>4 cm的亚组中，MetS是术后OS的保护因素（HR=0.377，95%CI：0.175-0.812，P=0.013）、CSS（HR=0.280，95%CI：0.113-0.690，P=0.006）和PFS（HR=0.332，95%CI：0.157-0.659，P=0.002）；肥胖是术后CSS的保护因素（HR=0.464，95%CI：0.219-0.981，P=0.044）和PFS（HR=0.445，95%CI：0.238-0.833，P=0.011）。Kaplan-Meier生存分析显示，MetS患者在OS（P=0.029）、CSS（P=0.021）和PFS（P=0.046）方面的长期生存率优于非MetS患者；对于肿瘤大小≤4 cm的亚组，有或无MetS的患者术后OS（P=0.702）、CSS（P=0.833）和PFS（P=0.339）无显著差异；对于肿瘤大小>4 cm的亚组，MetS患者的OS（P=0.010）、CSS（P=0.003）和PFS（P=0.001）优于非MetS患者。
MetS是ccRCC患者术后OS、CSS和PFS的保护因素，在肿瘤大小>4 cm的亚组中更为明显。MetS的组成成分肥胖与术后OS和CSS相关。
