合并第二原发雌激素相关肿瘤的肾细胞癌的临床特征：倾向评分匹配分析

田　熙; 徐文浩; 瞿元元; 王　骏; 王弘恺; 曹达龙; 施国海; 张海梁; 叶定伟

doi:10.19401/j.cnki.1007-3639.2019.12.004

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合并第二原发雌激素相关肿瘤的肾细胞癌的临床特征：倾向评分匹配分析

更新时间：2026-01-27

- 合并第二原发雌激素相关肿瘤的肾细胞癌的临床特征：倾向评分匹配分析
- Clinical features of renal cell carcinoma carrying second primary estrogen-related tumors: propensity score matching analysis
- 中国癌症杂志 2019年29卷第12期页码：941-947
- 作者机构：
  
  复旦大学附属肿瘤医院泌尿外科，复旦大学上海医学院肿瘤学系,上海,200032
- 作者简介：
- 基金信息：
  
  国家自然科学基金（81802525，81202004）;上海市自然科学基金（16ZR1406400）;上海市“医苑新星”青年医学人才培养资助计划。
- DOI：10.19401/j.cnki.1007-3639.2019.12.004
  中图分类号：
- 网络出版：2020-01-08，
  
  纸质出版：2020-01-08
- 稿件说明：
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田　熙, 徐文浩, 瞿元元, 王　骏, 王弘恺, 曹达龙, 施国海, 张海梁, 叶定伟. 合并第二原发雌激素相关肿瘤的肾细胞癌的临床特征：倾向评分匹配分析[J]. 中国癌症杂志, 2019, 29(12): 941-947.

TIAN Xi, XU Wenhao, QU Yuanyuan, et al. Clinical features of renal cell carcinoma carrying second primary estrogen-related tumors: propensity score matching analysis[J]. China Oncology, 2019, 29(12): 941-947.
田　熙, 徐文浩, 瞿元元, 王　骏, 王弘恺, 曹达龙, 施国海, 张海梁, 叶定伟. 合并第二原发雌激素相关肿瘤的肾细胞癌的临床特征：倾向评分匹配分析[J]. 中国癌症杂志, 2019, 29(12): 941-947. DOI： 10.19401/j.cnki.1007-3639.2019.12.004.

TIAN Xi, XU Wenhao, QU Yuanyuan, et al. Clinical features of renal cell carcinoma carrying second primary estrogen-related tumors: propensity score matching analysis[J]. China Oncology, 2019, 29(12): 941-947. DOI： 10.19401/j.cnki.1007-3639.2019.12.004.

摘要

背景与目的：随着肿瘤诊疗技术的进步，肿瘤患者的生存时间不断延长，第二原发肿瘤在临床上的报道也越来越多。探讨合并第二原发雌激素相关肿瘤的肾细胞癌（renal cell carcinoma，RCC）临床和病理学特征。方法：回顾性纳入2008年1月—2019年1月复旦大学附属肿瘤医院诊治的女性RCC患者520例，其中合并第二原发雌激素相关肿瘤39例，单一RCC 481例。本研究应用倾向评分匹配（propensity score matching，PSM）法对两类患者临床资料按1∶5进行匹配，比较两组患者临床病理学特点［年龄、体质量指数（body mass index，BMI）、肿瘤家族史、TNM分期、美国癌症联合会（American Joint Committee on Cancer，AJCC）临床分期等］。通过Kaplan-Meier法统计合并第二原发雌激素相关肿瘤RCC患者和单一RCC患者的预后情况。结果：经过倾向评分匹配后，合并第二原发雌激素相关肿瘤38例，单一RCC 185例。两组患者肿瘤家族史倾向评分匹配前差异有统计学意义（P=0.012），匹配后，两组患者肿瘤家族史差异有统计学意义（P=0.042）。倾向评分匹配前两组患者总体生存情况差异有统计学意义（P=0.014），倾向评分匹配后共纳入患者223例，所有患者都获得随访，随访时间为3~130个月，其中合并第二原发雌激素相关肿瘤组患者死亡8例，存活30例，中位生存时间为34.5个月，单一RCC组患者死亡57例，存活128例，中位生存时间为59.0个月。在随访时间内，合并第二原发雌激素相关肿瘤组的生存率均低于单一RCC组，两组总体生存情况相比较，差异有统计学意义（P=0.041）。结论：合并第二原发雌激素相关肿瘤的RCC并不少见，而肿瘤家族史可能使雌激素相关肿瘤患者再发RCC的风险升高。当合并第二原发雌激素相关肿瘤时，RCC患者的预后显著较单一RCC患者更差。

Abstract

Background and purpose: With the progress of tumor diagnosis and treatment

the survival time of tumor patients continues to prolong

and there are increasing number of clinical reports about second primary carcinoma. The purpose of this study was to investigate the clinical and pathological features of renal cell carcinoma (RCC) with second primary estrogen-related tumors. Methods: A total of 520 female RCC patients undergoing surgery in Fudan University Shanghai Cancer Center from Jan. 2008 to Jan. 2019 were retrospectively enrolled

including 39 cases carrying second primary estrogen-related tumors and 481 cases with only primary RCC. This study compared clinicopathological features in two groups

including age

body mass index (BMI)

family history of cancer

TNM staging and American Joint Committee on Cancer (AJCC) clinical staging. Propensity score matching (PSM) was applied to match two groups in 1:5 ratio. In addition

the Kaplan-Meier method was performed to assess the prognosis of the two groups. Results: After construction of PSM algorithm

38 patients carrying second primary estrogen-related tumor and 185 single RCC patients were enrolled for analysis. Before PSM analysis

statistically significant difference was found between two groups in family history of cancer (P=0.012). After performing PSM algorithm

there was still statistically significant difference between the two groups of patients (P=0.042). Before PSM analysis

statistically significant difference was found between two groups in overall survival (P=0.014). After performing PSM algorithm

a total of 223 female RCC patients were enrolled and followed up for 3-130 months. Among the 38 patients carrying second primary estrogen-related tumor

8 patients died

while 30 patients were still alive with a median survival time of 34.5 months. Among the 185 single RCC patients

57 patients died

while 128 patients were still alive with a median survival time of 59.0 months. During the follow-up

the survival rate of patients carrying second primary estrogen-related tumor was always lower than that of single RCC patients. Statistically significant difference was found between two groups in overall survival (P=0.041). Conclusion: RCC patient carrying second primary estrogen-related tumor is not uncommon

and family history of cancer may increase the risk of RCC in patient carrying second primary estrogen-related tumor. The prognosis of RCC patient carrying second primary estrogen-related tumor is worse than that of patients with only RCC.

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