2002-2012年上海市浦东新区直肠癌患者生存情况分析  

Analysis on factors associated with the survival rate of the patients with rectal cancer in Pudong new area diagnosed from 2002to 2012

作　　者：李小攀[1] 杨琛[1] 杨黎明[1] 孙乔[1] 闫蓓[1] 张美玉[1] 李晓莉[1] 孙良红[1] 王莉红[1] 

机构地区：[1]上海市浦东新区疾病预防控制中心肿瘤伤害防治与生命统计科,上海200136

出　　处：《中华肿瘤防治杂志》2015年第10期738-741,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：上海市卫生和计划生育委员会科研课题面上项目(20134128);上海市浦东新区卫生系统重点专科(病)建设项目(PWZz2013-15);上海市浦东新区卫生计生委卫生科技项目(PW2013D-12)

摘　　要：目的分析上海市浦东新区直肠癌患者的生存情况,为直肠癌防治工作提供参考依据。方法采用上海市肿瘤病例登记报告系统,收集上海市浦东新区2002-01-01-2012-12-31首次诊断为直肠癌的5 002例患者信息。应用Kaplan-meier法、Log-rank检验和Cox多元回归模型分析其诊断年龄、性别和TNM分期等信息与患者总体生存率的相关性。结果 5 002例直肠癌患者平均生存期为74.19个月,中位生存期为62个月,1年生存率为68.06%,2年为59.80%,3年为54.19%,4年为50.36%,5年为47.04%。不同患者组中位生存期比较,TNM高分期（Ⅲ~Ⅳ）组患者为34个月,低于TNM低分期（Ⅰ~Ⅱ）组患者的142个月,χ2=336.250,P〈0.001;诊断高年龄组（≥66岁）的患者为36个月,低于诊断低年龄组〈66岁患者的142个月,χ2=301.092,P〈0.001;尚未发现直肠癌患者的总体生存率与性别（χ2=0.788,P=0.375）和居住地（χ2=0.071,P=0.789）有统计学关联;经诊断年龄、性别和居住地等因素调整后,Cox回归模型分析结果表明,肿瘤TNM高分期是直肠癌患者总体生存率降低的独立危险因素,HR=2.795,95%CI为2.489~3.137,P〈0.001。结论直肠癌患者的预后与诊断年龄及肿瘤分期明显相关,争取肿瘤早发现并关注低龄及高龄的患者人群的健康是提高直肠癌患者生存期的有效措施。OBJECTIVE To explore the survival rate of patients with rectal cancer in Pudong New Area for provi- ding a reference for the prevention and predicting the patients prognosis. METHODS According to Cancer Reporting System in Shanghaisubsets of 5002 patients with rectal cancer diagnosed from 2002 to 2012 were collected from Pudong new area to screen the potential risk factors associated with the survival rate by Kaplan-meier method,Log-rank test and Cox regression analysis,such as age,Tumor Node Metastasis （TNM） stage, gender, and residential areas. RESULTS In the 5 002 patients, the average survival time was 74. 19 months, the median survival time was 62 months and the 1 to 5 years survival rates were 68.06 %, 59.80 %, 54.19 %, 50.36 % and 47.04% respectively. Comparing with the different groups＂ median survival time,the patients with Ⅲ or IV stage were 34 months,lower than the 142 months of those with Ⅰ or Ⅱ stage（X2 = 336. 250, P%0. 001）, and that in the patients of high age group（≥66 years old at diagnosis） were 36 months,lower than the 142 months of those in the lower age group （X2 =301. 092 ,P〈0. 001）. There were no statisti- cal significances in gender （X2 = 0.788, P = 0.375） and residential areas （？（X2= 0.071, P = 0.789）. Cox multivariate regres- sion analysis showed that the HR of late-stage tumor was 2. 795, and 95% CI was 2. 489--3. 137 （P〈0. 001） after control- ling those factors,such as diagnose age,gender and address. CONCLUSION The prognosis of patients with rectal cancer is significantly related with age and tumor staging.

关 键 词：肿瘤 直肠肿瘤 生存率 上海市 

分 类 号：R735.37[医药卫生—肿瘤]