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目的:总结Stauffer综合征的临床特点,并讨论其临床意义。方法:回顾分析1999年1月至2007年9月本院收治的37例伴Stauffer综合征的肾癌患者的临床资料,并应用统计学方法分析其预后的影响因素。结果:37例伴Stauffer综合征肾癌患者的1、3、5年生存率分别为78.4%(29/37)、65.4%(17/26)和43.8%(7/16)。术后肝功能恢复者1年和3年生存率分别为89.3%(25/28)和78.9%(15/19),均显著高于术后肝功能无改善者(4/9和2/7,P<0.05),而5年生存率在两者间差异无统计学意义(6/12和1/4,P>0.05)。单因素Cox回归分析结果提示,伴Stauffer综合征肾癌患者的预后与性别、肿瘤大小、美国癌症联合会(AJCC)分期、血清胆红素(BIL)及白蛋白(ALB)水平相关(P<0.05)。结论:伴Stauffer综合征肾癌患者的预后较差。术后肝功能恢复的情况可作为判断此类患者短期预后的指标之一,但不能反映长期生存率。术后连续监测肝功能可能有助于尽早发现局部复发及远处转移的病灶。
Objective: To summarize the clinical features of Stauffer syndrome and to discuss its clinical significance. Methods: The clinical data of 37 patients with renal cell carcinoma with Stauffer’s syndrome treated in our hospital from January 1999 to September 2007 were retrospectively analyzed. The influencing factors of prognosis were analyzed statistically. Results: The 1, 3, 5-year survival rates of 37 patients with Stauffer’s syndrome and renal cell carcinoma were 78.4% (29/37), 65.4% (17/26) and 43.8% (7/16), respectively. The 1-year and 3-year survival rates of patients with postoperative recovery were 89.3% (25/28) and 78.9% (15/19), respectively, which were significantly higher than those with no improvement of postoperative liver function (4/9 and 2/7 , P <0.05). However, the 5-year survival rate was not significantly different between the two groups (6/12 and 1/4, P> 0.05). The results of univariate Cox regression analysis showed that the prognosis of patients with renal cell carcinoma of Stauffer’s syndrome correlated with gender, tumor size, AJCC stage, serum bilirubin (BIL) and albumin (ALB) (P < 0.05). Conclusion: Patients with Stauffer’s syndrome have a poor prognosis. Postoperative recovery of liver function can be used as one of the indicators to determine the short-term prognosis of such patients, but can not reflect the long-term survival. Continuous postoperative monitoring of liver function may be helpful to early detection of local recurrence and distant metastasis lesions.