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目的:分析上海市浦东新区原发性肾细胞癌患者的发病和生存情况。方法:以2002—2011年上海市浦东新区常住户籍居民为研究对象,按世界标准人口计算原发性肾细胞癌标化发病率及死亡率,应用Kaplan-Meier法和COX多元回归模型分析不同性别、不同地区、不同TNM分期和是否手术的原发性肾细胞癌患者的生存情况。结果:2002—2011年原发性肾细胞癌新发1905例,男性1234例、女性671例;男性标化发病率(5.71/10万人年)高于女性(3.07/10万人年)。原发性肾细胞癌相关死亡697例,男性453例、女性244例;男性标化死亡率(1.88/10万人年)高于女性(0.92/10万人年)。原发性肾细胞癌患者1～5年生存率分别为74.75%、69.84%、66.38%、63.40%和61.44%。中心城区与其他地区、TNM高分期组与低分期组、手术切除组与非手术组患者的总体生存率之间差异有统计学意义(P=0.040,P<0.001,P<0.001)。不选择手术治疗和TNM高分期是原发性肾细胞癌患者生存率降低的独立危险因素(P<0.001)。结论:浦东新区原发性肾细胞癌的男性发病率和死亡率高于女性,中心城区居民高于区域内其他地区。手术治疗和肿瘤早发现可明显改善原发性肾细胞癌患者的预后。
Objective: To analyze the incidence and survival of patients with primary renal cell carcinoma in Shanghai Pudong New Area. Methods: From 2002 to 2011, permanent resident population in Shanghai Pudong New Area was used as research object to calculate the incidence and mortality of primary renal cell carcinoma according to the world standard population. Kaplan-Meier method and COX multiple regression model were used to analyze the gender , Different regions, different TNM staging and whether the surgical treatment of primary renal cell carcinoma in patients with survival. Results: There were 1905 new cases of primary renal cell carcinoma in 2002-2011, including 1234 males and 671 females. The standardized incidence of males (5.71 per 100,000 person-years) was higher than that of females (3.07 per 100,000 person-years). There were 697 cases of primary renal cell cancer related deaths, 453 males and 244 females. The male standardized mortality rate (1.88 per 100,000 person-years) was higher than that of females (0.92 per 100,000 person-years). The 1- 5-year survival rate of patients with primary renal cell carcinoma was 74.75%, 69.84%, 66.38%, 63.40% and 61.44%, respectively. There was a significant difference in the overall survival rate between central urban area and other regions, TNM high staging group and low staging group, surgical resection group and non-surgical group (P = 0.040, P <0.001, P <0.001). Unselected surgery and TNM hyperinflation were independent risk factors for survival in patients with primary renal cell carcinoma (P <0.001). Conclusions: The incidence and mortality of primary renal cell carcinoma in Pudong New Area are higher than those in women. The population in downtown area is higher than that in other areas in the area. Surgical treatment and early detection of tumors can significantly improve the prognosis of patients with primary renal cell carcinoma.