徐 辉,吴志军,张 澄,等.1991例以医院为基础的胃癌双向性队列研究患者生存分析[J].肿瘤学杂志,2023,29(10):847-852.
1991例以医院为基础的胃癌双向性队列研究患者生存分析
Survival Analysis of Patients with Gastric Cancer: A Hospital-Based Bidirectional Cohort Study
投稿时间:2023-03-06  
DOI:10.11735/j.issn.1671-170X.2023.10.B007
中文关键词:  胃肿瘤  肿瘤登记/以医院为基础  生存随访  生存率
英文关键词:gastric cancer  cancer registration/hospital-based registry  survival follow-up  survival rate
基金项目:安徽省重点研究与开发计划项目(1804b06020351);安徽医科大学第一附属医院临床研究项目(LCYJ2021YB015);安徽医科大学校基金资助项目(2022xkj160)
作者单位
徐 辉 安徽省肿瘤防治所/安徽省肿瘤防治办公室 安徽医科大学第一附属医院 
吴志军 马鞍山市人民医院 
张 澄 安徽省肿瘤防治所/安徽省肿瘤防治办公室 安徽医科大学第一附属医院 
张小鹏 合肥市疾病预防控制中心 
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中文摘要:
      摘 要:[目的]分析安徽医科大学第一附属医院2008年3月至2021年8月胃癌住院治疗患者的生存率,为胃癌综合防治策略提供依据。 [方法] 于2018年建立以医院为基础的胃癌双向性队列研究数据库,采用主动随访与被动随访结合的方式获取患者生存信息。用Kaplan-Meier法计算生存率并绘制生存曲线,采用反式Kaplan-Meier法计算中位随访时间,单因素分析采用Log-rank检验。[结果] 1 991例胃癌患者男女比例为2.51∶1,平均发病年龄(60.60±11.30)岁,整体中位生存时间18.20个月(95%CI:17.10~19.70),随访率97.99%,失访率2.01%。50岁以上病例数明显增多,60~69岁年龄组病例最多,50~79岁的病例占80.01%。胃癌患者的1年、3年、5年、10年观察生存率分别为65.46%、25.77%、14.87%、8.49%。40~49岁年龄组患者生存率最高,随着诊断年龄的提高,生存率总体上呈现逐渐降低趋势(χ2=73.00,P<0.01)。低分化组病例最多(61.98%),中分化组生存率最高(χ2=96.10,P<0.01);腺癌病例最多(90.86%),生存率最高(χ2=24.80,P<0.01);TNM分期Ⅰ期患者生存率最高,Ⅱ期、Ⅲ期、Ⅳ期患者生存率逐渐降低(χ2=743.00,P<0.01);不同性别患者生存率差异无统计学意义(P>0.05)。[结论] 胃癌患者的生存率偏低,应重点关注年龄、分化程度、病理类型和TNM分期对预后的影响,加强胃癌的早期筛查和规范化诊疗,提高患者生存率。
英文摘要:
      Abstract: [Objective] To analyzed the survival of hospitalized patients with gastric cancer. [Methods] A hospital-based bidirectional cohort study database was established among patients with gastric cancer admitted in the First Affiliated Hospital of Anhui Medical University from March 2008 to August 2021. The survival information of patients was obtained by combining active and passive follow-up. Kaplan-Meier method was used to calculate the survival rate and to draw the survival curve, and the inverse Kaplan-Meier method was used to calculate the median follow-up time. Log-rank test was used for univariate analysis. [Results] The data of 1 991 patients with gastric cancer were collected, with a male to female ratio of 2.51∶1 and a mean onset age of(60.60±11.30) years old. The overall median survival time was 18.20 months(95%CI: 17.10~19.70), the follow-up rate was 97.99%, and the lost follow-up rate was 2.01%. Most patients were in the age group of 60 to 69 years old, and patients aged 50 to 79 years old accounted for 80.01% of all cases. The 1-year, 3-year, 5-year and 10-year observed overall survival(OS) rates were 65.46%, 25.77%, 14.87% and 8.49%, respectively. The survival rate of patients aged 40~49 years old was the highest. With the increase of diagnosis age, the survival rate showed a decreasing trend(χ2=73.00, P<0.001). Patients with poorly differentiated gastric cancer accounted for 61.98%, while patients with moderately differentiated disease had the highest survival rate(χ2=96.10, P<0.01). Patients with adenocarcinoma had the highest proportion(90.86%) in all pathological types and they had the highest survival rate(χ2=24.80, P<0.01). The survival rate of TNM stage Ⅰ was the highest, followed by TNM stage Ⅱ, Ⅲ and Ⅳ(χ2=743.00, P<0.01). There was no significant difference in survival rate between male and female patients(P>0.05). [Conclusion]The survival rate of gastric cancer patients is relatively low. Age, tumor differentiation, pathological type and TNM stage have impact on survival and prognosis of patients. Early screening and standardized diagnosis and treatment will improve the survival rate of patients with gastric cancer.
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