上海市闵行区2002～2012年胃癌发病与Cox生存分析  

The Incidence and Cox Survival Analysis of Gastric Cancer in Minhang District of Shanghai from 2002 to 2012

作　　者：张芬[1] 周洁[1] 李为希[1] 严玉洁[1] 许慧琳[1] 刘奕男[1] 徐东丽[1] 方红[1] 

机构地区：[1]上海市闵行区疾病预防控制中心,上海201101

出　　处：《中国肿瘤》2016年第8期595-599,共5页China Cancer

摘　　要：[目的]描述上海市闵行区2002～2012年胃癌发病情况,追踪2002～2008年新发胃癌患者至今生存情况以阐明早期诊断对胃癌预后的影响。[方法]资料来源于上海市疾病预防控制中心的肿瘤登记报告和随访管理系统,采用世界人口进行标化,分析不同性别的胃癌发病率,并采用变化百分比（pencent change,PC%）及年度变化百分比（annual percent change,APC%）描述年度变化趋势;应用SPSS16.0软件进行卡方检验描述性别、年份、发病年龄对胃癌病例早期诊断的影响及采用Kaplan-Meier生存分析与Cox回归分析揭示早期诊断对胃癌死亡风险的影响。[结果]2002～2012年胃癌发病呈逐年下降趋势,年度变化百分比为-3.343%,男性胃癌发病率高于女性,发病率随着年龄的增加而增加。病例早期诊断比例随着年龄呈倒＂U＂型分布。2002～2008年诊断出2525病例。5年生存率为29.67%,Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期、Ⅴ期患者5年生存率分别为76.27%、57.88%、31.12%、6.60%和22.96%。Ⅳ期患者生存时间最短,中位生存期仅171天。Cox回归分析结果显示Ⅱ期、Ⅲ期、Ⅳ期、Ⅴ期患者发生死亡的风险度为Ⅰ期的2.066倍、3.580倍、9.535倍和4.670倍。年龄每增加1岁,发生死亡的风险增加0.034倍。[结论]2002～2012年期间闵行区胃癌总体发病率呈逐年下降趋势,50～80岁为胃癌高发人群,早期诊断对提高肿瘤患者的生存时间存在较大影响。[Purpose] To describe the incidence of gastric cancer in Minhang district from 2002 to2012 and clarify the effect of early diagnosis on the prognosis of gastric cancer by following up the survival of patients with newly diagnosed gastric cancer from 2002 to 2008. [Methods] Incidence of gastric cancer data（2002～2012） were collected by Shanghai Cancer Registry and follow-up management system,percent change（PC） and annual percent change（APC） were estimated to analyze the time trend of incidence. SPSS16.0 software was used to describe the effect of gender,years and age on early diagnosis of gastric cancer and reveal the impact of early diagnosis on the risk of death by Kaplan-Meier survival analysis and Cox regression analysis. [Results] From 2002 to2012,the incidence of gastric cancer decreased year by year,the annual percentage change ratio was-3.343%,the incidence of male was higher than female,but both increased by aging. The proportion of the early diagnosis of the patients showed an inverted ＂U＂ type distribution. In 2525 patients diagnosed from 2002 to 2008,the five years survival rate was 29.67%,the five years survival rate of the phase Ⅰ,Ⅱ,Ⅲ,Ⅳ,Ⅴ were 76.27%,57.88%,31.12%,6.60% and 22.96% respectively. The Ⅳ phase patients had a shortest survival time of 171 days,and early patients had a largest survival time. Cox regression analysis showed that risk of death of stage Ⅱ and stage Ⅲ, Ⅳ,Ⅴpatients was 2.066,3.580,9.535 and 4.670 times than stage Ⅰ patients respectively. The risk of death would increase by 0.034 times with the age rise. [Conclusions] From 2002 to 2012,the overall incidence of gastric cancer in Minhang district decreased year by year. The high-risk population of gastric cancer was 50 years old to 80 years old. The early diagnosis had great influence on the survival time and survival rate of five years.

关 键 词：胃癌 发病率 生存率 COX回归 

分 类 号：R735.2[医药卫生—肿瘤]