天津医药

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儿童横纹肌肉瘤的预后的影响因素分析

郭芬1,赵 强2   

  1. 1. 天津市肿瘤医院
    2. 天津医科大学附属肿瘤医院
  • 收稿日期:2011-03-15 修回日期:2011-05-12 出版日期:2011-12-15 发布日期:2011-12-15
  • 通讯作者: 郭芬

Analysis and discuss of Prognostic Factors for pediatric Rhabdomyosarcoma

  • Received:2011-03-15 Revised:2011-05-12 Published:2011-12-15 Online:2011-12-15

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摘要： 摘要 目的:探讨儿童横纹肌肉瘤（RMS）的临床病理特征及预后影响因素。方法: 回顾性分析我科93例RMS患儿的临床及生存资料，引入患儿性别、年龄、肿瘤大小、原发部位、组织学类型、COG-stage分期、COG-group分期、危险度分组和手术情况共9个因素。采用COX回归模型进行多因素分析，确立预后独立影响因素，采用Kaplan-Meier生存曲线和Log-rank检验比较独立影响因素与生存率的关系。结果: 全组1年、3年、5年生存率分别为90.3%、62.0%、43.1%，总体中位生存期为47.28个月。多因素分析显示组织学类型、原发部位、group分期和是否手术切除是儿童RMS预后的影响因素。生存分析提示组织学类型、原发部位、group分期及是否手术切除的预后差异均有统计学意义（均P＜0.001）。结论: 儿童RMS预后的独立影响因素有组织学类型、原发部位、group分期和是否手术切除，通过此分析能为预后判断和临床治疗强度的选择提供依据。

关键词: 横纹肌肉瘤, 回归分析, 存活率分析, 回顾性研究, 预后, 儿童

Abstract: [Abstract] Objective To explore the clinicopathological characteristics and prognostic factors of pediatric Rhabdomyosarcoma by the retrospective study of clinical and survival data of 93 patients,who were diagnosed RMS.Method The clinical datain cluding sex,age,tumor size,primary site, histological subtypes, COG-staging,COG-grouping,risk classification and surgery were analyzed. We used multi-variety analysis with COX regression model to identify the independent prognosis factors,Influence of the above factors on the survival rate was analyzed by Kaplan-Meier curve and Log-rank test. Results Survival rates of 1-,3-and 5-year in pediatric were 90.3%,62.0%,43.1%,respectively,and the median overall survival time was 19.43 months. Multivariable analysis showed that the histological subtypes, primary site , COG-grouping and surgical resection are independent prognosis factors.The survival analysis showed that there were significant ststistical differences in the prognostic differences of the histological subtypes（P＜0.001）, primary site （P＜0.001）, COG-grouping（P＜0.001） and surgical resection（P＜0.001）.Conclusion The independent prognosis factors of pediatric Rhabdomyosarcoma including histological subtypes, primary site,COG-grouping and surgical resection.It can be used to predict the prognosis and provide the basis data for clinical treatment.