| Objective:To analyze the clinicopathological characteristics and prognostic factors of different subtypes of papillary renal cell carcinoma,and to evaluate the impact of subclassification of PRCC on the prognosis of patients.Methods: A retrospective analysis of 101 cases of PRCC patients admitted to our hospital from January 2003 to October2019,of which 49 cases were diagnosed as type 1 PRCC(48.5%)and 52 cases were diagnosed as type 2 PRCC.51.5%),61 males(60.4%),40 females(39.6%),and the male to female ratio was 1.525: 1.Aged 16-81 years,with an average of(52.76 ± 13.25)years.64 cases(63.37%)were asymptomatic kidney cancer;37 cases(36.63%)had clinical symptoms,of which gross hematuria was 11(10.89%),19 cases of low back pain(18.81%),6 cases of hematuria with low back pain(5.94%),abdominal One patient had a mass(0.99%).There were 24 cases(23.76%)with hypertension and 7 cases(6.93%)with diabetes.The tumor was located in 47 cases(46.53%)of the left kidney and 54 cases(53.47%)of the right kidney.Tumors were located in 30 cases(29.70%)of the upper pole,44 cases(43.57%)of the middle,and 27 cases(26.73%)of the lower pole.The average tumor size was 4.21 ± 1.988 cm.All 101 patients underwent surgical treatment,including33(32.67%)open surgery,66(65.35%)laparoscopic surgery,44(43.56%)radical nephrectomy,and 56(55.44%)nephron-sparing surgery.Among the 101 patients with papillary renal cell carcinoma,81 were in T1(80.2%),13 were in T2(12.87%),3 were in T3 and above(2.97%),and 93 were in patients with pathological N stage N0.(92.07%),4patients(3.96%)with pathological N stage N1,54(82.6%)with Fuhrman grade 1 and 2and 36(82.6%)with Fuhrman grade 3 and 4.Mean ± standard deviation is used to describe the distribution of quantitative data of normal distribution,independent sample ttest is used to compare the differences between groups,and median(25th to 75 th percentile)is used to describe the distribution of non-normally distributed quantitative data.Differences between groups were compared using the Mann-Whitney U test.Frequency and composition ratio are used to describe the distribution of qualitative data.Chi-square test is used to compare differences between groups.Kaplan-Meier method is used to analyze survival and draw survival curves.Log-rank method is used to compare survival differences between groups.One-way analysis is meaningful.The factors were independent variables.Multivariate cox regression analysis was used to explore the independent influencing factors that influence the prognosis of patients.Results: Among101 cases,49 were type 1 PRCC and 52 were type 2 PRCC.The average follow-up time was 48.7 months,and the lost rate was 2.97%(3 / 101).The 1,3,and 5-year overall survival rates of patients with type 1 PRCC were 97.78%,97.56%,and 97.78%,and the 1,3,and 5 years overall survival rates of patients with type 2 PRCC were 84.53%,93.87%,and 71.17%.The Kaplan-Meier survival curve showed that the OS of patients with type 2PRCC at 3 and 5 years was significantly lower than that of type 1 PRCC,and the difference was statistically significant.Multivariate cox regression analysis showed that diabetes(HR = 27.95,P = 0.002),histological classification(HR = 24.37,P = 0.005),surgical method(HR = 7.524,P = 0.02),pathological N stage(HR = 18.705,P = 0.006)is an independent influencing factor affecting the survival of patients.Conclusion: Type 2PRCC has a higher nuclear grade and is more common in elderly patients.The prognosis of type 1 is obviously better than that of type 2.The histological subtypes of PRCC,diabetes,surgical methods,and pathological N staging are independent factors that affect patient survival. |
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