| Objective:To compare the differences in clinical features,treatment methods and survival prognosis of different pathological types of non-clear cell renal cell carcinoma,and to analyze factors affecting the survival.Methods:The clinical and pathological data of 122 patients with nccRCC who are admitted to the Department of Urology the First Affiliated Hospital of Chongqing Medical University from January 2013 to December2019 were retrospectively analyzed,and to inqury their survival conditions.The endpoint of the study is tumor gets progression.Compare the differences in chRCC,pRCC,Mit FRCC,MTSCC-K,CDC,sRCC,renal squamous cell carcinoma,uRCC of clinical features,treatment methods,postoperative progression-free survival(PFS).Analyze the effects of age,gender,BMI,clinical symptoms,history of chronic diseases,surgical methods,pre-albumin,albumin,globulin,NLR,PLR,LMR,and Fbg levels on the prognosis.SPSS23.0 software was used for statistical analysis,measure data using t-test,count data using χ2 test,survival data using Kaplan-Meier method to calculate and use Log-rank method to test,univariate and multivariate regression models determine the independent risk factors which are affecting prognosis.Results:1.There are 46 cases(37.7%)in the chRCC group,36 cases in the pRCC group(29.5%),14 cases in the Mit FRCC group(11.5%),6cases in the MTSCC-K group(4.9%),6 cases in the CDC group(4.9%)),4cases(3.3%)in the sRCC group,3 cases(2.5%)in the squamous cell carcinoma group,and 7 cases(5.7%)in the uRCC group.2.There are 60 male patients and 62 female patients;the average age is 54.7±15.1 years.3.On the date of follow-up,22 patients had tumor progression after surgery,and 14 patients died.The overall 1-year,3-year,and 5-year PFS rates were 88.4%,81.8%,and 76.5%.The uRCC group has the best prognosis with 3-year PFS rate is 100%,followed by the chRCC group with 3-year PFS rate of 97.6%,and the pRCC group with 3-year PFS rate of 83.7%;the squamous cell carcinoma group has the worst prognosis with3-year PFS rate is 0.4.Univariate regression analysis showed that patients with the symptoms of bachache,diabetes,preoperative pre-albumin≤152mg/L,preoperative albumin≤41g/L,preoperative globulin≥31g/L,preoperative albumin /globulin≤1.3,preoperative NLR≥2.6,preoperative PLR≥173.9,preoperative LMR≤3.2,preoperative Fbg≥4.9g/L,radical nephrectomy,T2-T4 stage,tumor involving the renal capsule are risk factors for tumor progression in nccRCC patients after surgery.5.Multivariate regression analysis showed that preoperative Fbg increase,T2-T4 stage tumors,and radical nephrectomy are independent risk factors of tumor progression.Among them,Fbg≥4.9g/L is the most influential risk factor.The risk of tumor recurrence or metastasis in the high Fbg group is 8.9 times higher than that of the low Fbg group.Conclusion:nccRCC is a rare type of kidney cancer,with an earlier age of onset,and different pathological types have different prognosis.Surgical treatment is an important method for limited-stage renal cell carcinoma.For advanced renal cell carcinoma,a comprehensive treatment centered with targeted therapy is mostly used.Preoperative nccRCC patients with Fbg≥4.9g/L and T2-T4 stage have a higher risk of tumor recurrence and metastasis after surgery. |
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