本文選題：腎母細(xì)胞瘤 + 肺轉(zhuǎn)移��； 參考：《安徽醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的探討WT患者發(fā)生肺轉(zhuǎn)移的高危因素,為評(píng)估預(yù)后提供依據(jù);總結(jié)WT患者發(fā)生肺轉(zhuǎn)移的生存情況,指導(dǎo)臨床治療和用藥。方法選取自2006年1月1日至2016年12月31日武警總醫(yī)院兒科經(jīng)病理確診的91例WT患兒的臨床資料為研究對(duì)象,其中男55例,女36例,中位年齡26(3-144)月。按照是否發(fā)生肺轉(zhuǎn)移將91例WT患者分為肺轉(zhuǎn)移組和無肺轉(zhuǎn)移組。搜集、整理兩組患兒首次就診時(shí)詳細(xì)臨床資料,包括年齡、性別、發(fā)病部位、首發(fā)癥狀及初診時(shí)腫瘤體積等。結(jié)果1.一般情況:91例WT患兒中肺轉(zhuǎn)移組18例(19.8%),男11例,女7例,中位年齡45.5(6-144)月;無肺轉(zhuǎn)移組73例(80.2%),男44例,女29例,中位年齡24(3-120)月。2.單因素相關(guān)因素分析:年齡≤24月:肺轉(zhuǎn)移組3例(16.7%),無肺轉(zhuǎn)移組39例(53.4%);24月:肺轉(zhuǎn)移組15例(83.3%),無肺轉(zhuǎn)移組34(46.6%),P值0.05。腫瘤負(fù)荷≥1000ml:肺轉(zhuǎn)移組12例(66.7%),無肺轉(zhuǎn)移組26(35.6%);1000ml:肺轉(zhuǎn)移組6例(33.3%),無肺轉(zhuǎn)移組47例(64.4%),P值0.05。術(shù)后分期:肺轉(zhuǎn)移組II、III期15例(83.3%);無肺轉(zhuǎn)移組II、III期39例(53.4%),P值0.05。在性別、病理組織學(xué)危險(xiǎn)度、首發(fā)癥狀(腹部包塊及其他分組,如血尿、腹痛、發(fā)熱、便秘等)及發(fā)病部位方面,P值0.05。3.療效:隨訪至2016年12月31日,肺轉(zhuǎn)移組的生存時(shí)間平均值是40.931月(95%置信區(qū)間,22.948-58.913月);無肺轉(zhuǎn)移組生存均值是103.539月(95%置信區(qū)間,90.799-116.279月)。肺轉(zhuǎn)移組18例:2例CR,3例PR,11例PD死亡,2例失訪;無肺轉(zhuǎn)移組73例:60例CR,10例復(fù)發(fā)(復(fù)發(fā)時(shí)間多在治療結(jié)束后半年至1年),死亡12例(復(fù)發(fā)死亡6例,PD死亡6例),1例心力衰竭死亡,1例放棄治療,5例失訪。肺轉(zhuǎn)移組18例死亡11例,總生存率是38.9%;無肺轉(zhuǎn)移組73例,死亡13例,總生存率是82.2%。肺轉(zhuǎn)移組2年OS(36.1%)低于無肺轉(zhuǎn)移組2年OS(86.0%)。結(jié)論WT肺轉(zhuǎn)移患兒發(fā)病年齡大于無肺轉(zhuǎn)移患兒;WT肺轉(zhuǎn)移患兒初診時(shí)腫瘤體積大、腹部分期為II、III期者多見;WT肺轉(zhuǎn)移患兒較無肺轉(zhuǎn)移總生存率低,預(yù)后差。
[Abstract]:Objective to investigate the high risk factors of lung metastasis in WT patients, to provide evidence for evaluating prognosis, to summarize the survival status of WT patients with lung metastasis, and to guide clinical treatment and medication. Methods from January 1, 2006 to December 31, 2016, 91 cases of WT children in pediatrics of Armed Police General Hospital were selected as the study objects, including 55 males and 36 females with median age of 263-144 months. According to the occurrence of lung metastasis, 91 WT patients were divided into lung metastasis group and no lung metastasis group. To collect and arrange the detailed clinical data of the first visit, including age, sex, location, initial symptoms and tumor volume of the first visit. Result 1. In general, there were 18 cases with lung metastasis (male 11, female 7, median age 45.56-144) months in the lung metastasis group, and 73 cases without lung metastasis group (44 males, 29 females, median age 243-120) months. Univariate correlation analysis: age 鈮，

本文編號(hào)：1842103