| Objective:Consulting the disease epidemiological status, clinical feature and treatment method data from the treated kidney-disease patient by Tianjin medical university No.2 hospital during Jan,2006 to Dec,2014, the study making conclusion and analysis aims to improve the diagnosis and treatment capability of renal cancer, and to better instruct on clinical work for patients.Methods:By analyzing the clinical data of 1,619 renal cancer cases treated by No.2 hospital from Jan,2006 to Dec,2014, the study make statistics and analysis from case to case including aspects of the basic patients’ situation, clinical manifestation, clinical stage, pathological consequence and the treatment methods. Quantitive data use “ ”, like age; Numerical date use “frequency/percentage”, like gender, first diagnosis symptoms, clinical stage, pathological consequence, surgery treatment ect. Use P<0.05 as standard. All data is analyzed by SPAA21.0 statistical software. Results:The 1619 renal cancer cases include 1,151 male case(71.09%) and 468 female case, with a ratio to 2.46:1 between male and female. Patients age ranges from 16 to 88 years old, and mainly at 50 and 60 years.(The 50 s and 60 s year old patients account for 56.14% in total number in Y2006, and in Y2007 the percentage is 65.30%, Y2008 64.24%,Y2009 65.30%,Y2010 57.90%, Y2011 63.84%,Y2012 64.57%,Y2013 64.56%,Y2014 70.09%). Average age is at 56.38 years old. And from 2006 to 2014, the yearly average age is at 53.57 ± 12.07,55.75 ± 11.21,55.76 ± 10.33,56.14 ±10.64,57.00 ± 11.56,57.16± 10.31,57.26 ± 10.74,57.28 ±11.41 and 57.49 ± 10.15. Statistic difference(P<0.05) shown among the yearly average age tells that the first diagnosis age is slightly increased. From 2006 to 2014, No.2 hospital received patients QTY is at 114,144,165,173,190,177,175,237,244 in each year, and this shows the patients receiving number is increased from No.2 hospital.According to the symptoms of first diagnosed renal cancer cases, the disease can be divided into symptomatic and asymptomatic cases. Totally 632 cases(39.04%) are with symptoms, from 2006 to 2014, the yearly percentage rate is at 43.76%,43.06%,41.82%,41.04%,40.53%,39.55%,37.71%,36.29%,33.20%.Asymptomatic cases number is 987(60.96%) with yearly percentage rate at 56.24%,56.94%,58.18%,58.96%,59.47%,60.45%,62.29%,63.71%,66.80%. Compared the two group statistic data, we can conclude the asymptomatic case is increased year by year. Analyzing from the clinical stages, we could find that in the symptomatic cases, T1 is 55.06%,T2 is 20.41%, T3 is 16.30%,T4 is 8.23%. And in the asymptomatic cases, T1 is 83.28%,T2 is 9.7%,T3 is 6.99%,T4 is 0. From which we can conclude the clinical stage performance in symptomatic cases is lower than cases in asymptomatic cases. In all the 1619 cases, most locate in asymptomatic/T1 stage with a percentage of 50.77%.If compared the pathological type, usual pathological types account to 89.87% in symptomatic cases, and unusual types account to 10.13%. And in asymptomatic cases the ratio between usual and unusual types is 97.26 to 2.74. From the statistic difference, it can conclude that unusual pathological type renal cancer is more likely happened in asymptomatic cases. If compared with the pathological level, with symptom cases include level-1 103 cases, level-2 361 cases, level-3 129 cases and level-4 39 cases. In asymptomatic cases, these numbers are 192 cases in level-1,685 cases in level-2, 96 cases in level-3 and 14 cased in level-4. It can be found that there are more cases in level-3&4 from symptomatic cases and shows that higher pathological level in symptom cases.From the surgery treatment method analysis, totally 1148 cases treated by ORN and account to 70.91%. This shows ORN is the main treatment surgery for renal cancer. Besides that, from 2011 to 2014, the LRN treatment cases are 14, 69, 98 and 110 cases respectively. Show that LRN treatment is more and more selected by patient in these years. Same trend also seen on NSS treatment, with 27,29,49,65 cases from year 2011 to 2014. Conclusion:1.Renal cell carcinoma morbidity rate of Tianjin medical university No.2 hospital is increasing. Patients are more male than female and most aged at 50 to 70 years old. With the development of medical technology, renal cell carcinoma can be found by regular physical examination. So it’s very important to increase public awareness and popularize community physical check for renal cancer’s early diagnosis and treatment. This is a way to increase live quality.2.With the application of new technology and inspection devices, renal cell carcinoma can be identified more accurately by doctor now. Especially for the early diagnosis of asymptomatic renal cancer, there is no need to depend on the traditional 3-symptoms methods. And more and more asymptomatic cases are found by with modern technology now.3.Till now, surgery is still the main treatment method for early renal cancers. Mainstream surgeries include RN and NSS. To be noticed, Laparoscopic surgery is more and more important for its micro-invasiveness, clear dissected tissue and rapid post-surgery rehabilitation. Application and investment of laparoscopic surgery should be increase in future. |
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