左右半结肠黏液腺癌术后患者生存特征分析:一项基于SEER数据库的研究  

Survival differences of postoperative patients with left⁃side and right⁃side colonic mucinous adenocarcino⁃ma:a study based on SEER database

作　　者：黄庆 邹旻红[2] 李旺林 曹杰 HUANG Qing;ZOU Minhong;LI Wanglin;CAO Jie(Department of General Surgery,Guangzhou First People′s Hospital,the Second Affiliated Hospital of South China University of Technology,Guangzhou 510180,China;不详)

机构地区：[1]广州市第一人民医院(华南理工大学附属第二医院)综合外科,广州510180 [2]中山大学附属第三医院超声科,广州510120 [3]广州市第一人民医院(华南理工大学附属第二医院)胃肠外科,广州510180

出　　处：《实用医学杂志》2021年第10期1351-1356,共6页The Journal of Practical Medicine

基　　金：国家自然科学基金(编号:81871943);广东省自然科学基金(编号:2017A030311035);广东省医学科研基金(编号:A2019526)。

摘　　要：目的探讨左右半结肠黏液腺癌(MA)术后患者的生存特征差异和预后因素。方法收集监测、流行病学、最终结果(SEER)数据库中2006-2015年结肠黏液腺癌术后患者总共13594例患者,分为两组:右半结肠黏液腺癌组(n=9824)和左半结肠黏液腺癌组(n=3770),使用Kaplan⁃Meier分析两组总生存期(OS),按分期、分化程度分层对比分析OS;多因素Cox分析左右半结肠黏液腺癌术后患者的预后影响因素。结果左右半结肠黏液腺癌术后患者各肿瘤特征中存在明显差异。左右半结肠黏液腺癌的5年生存率分别是51.6%和55.0%,生存分析两组差异无统计学意义(P=0.234)。分层分析显示在AJCC分期Ⅰ期(P=0.203)、Ⅱ期(P=0.156)、Ⅲ期(P=0.08)、高分化(P=0.091)、中分化(P=0.252)和未分化(P=0.946)的左右半结肠黏液腺癌的OS对比差异无统计学意义。Ⅳ期左半结肠黏液腺癌的OS要优于右半结肠黏液腺癌(P<0.001);而低分化的右半结肠黏液腺癌的OS要优于左半结肠黏液腺癌(P=0.001)。多因素Cox分析显示,男性、年龄≥60岁、单身或未婚、丧偶、T3、T4、N1、N2、M1、低分化、未分化、淋巴结获取数量<12、CEA阳性和无化疗分别是左右半结肠黏液腺癌术后患者预后的危险因素,中分化是左半结肠黏液腺癌术后患者预后的危险因素。结论不同分化程度和分期的左右半结肠黏液腺癌术后患者表现出不完全一致的生存差异。左右半结肠黏液腺癌术后患者预后的危险因素也不完全一致。Objective To investigate the differences in survival characteristics and prognostic factors of postoperative patients with left⁃side and right⁃side colonic mucinous adenocarcinoma(MA).Methods A total of 13594 patients with colonic MA after surgery from 2006 to 2015 were collected in the Surveillance,Epidemiology,and Final Results(SEER)database.They were divided into right⁃side MA group(n=9824)and left⁃side colonic MA group(n=3770).Overall survival(OS)of the two groups was estimated using the Kaplan⁃Meier method and stratified analysis was conducted by stage and degree of differentiation.The prognostic factors of patients with left⁃side and right⁃side colonic MA were evaluated using multivariate COX regression analyses.Results There were differences in the tumor characteristics of the left⁃side and right⁃side colonic MA patients.The 5⁃year survival rates of the left⁃side and right⁃side MA were 51.6%and 55.0%,respectively,and there was no difference in overall sur⁃vival between the two groups(P=0.234).Stratified analysis revealed there was no difference in the OS between the left⁃side and right⁃side colonic MA in the AJCC staging stageⅠ(P=0.203),stageⅡ(P=0.156),stageⅢ(P=0.08),well differentiated(P=0.091),moderately differentiated(P=0.252)and undifferentiated(P=0.946).The OS of the left⁃side group was better than that of the right⁃side group in stageⅣcolonic MA(P<0.001).However,the OS was better in the right⁃side group compared with that in the left⁃side group in poorly differentiated colonic MA(P=0.001).Multivariate COX analysis showed that male,aged over 60,single or unmarried,widowed,stage T3,stage T4,stage N1,stage N2,stage M1,poorly differentiated,undifferentiated,number of lymph nodes less than 12,CEA positive,and no chemotherapy were independent risk factors of postoperative patients with left⁃side or right⁃side colonic MA.Moderately differentiated was also an independent risk factor for the prognosis of postoperative patients with left colonic MA.Conclusion T

关 键 词：左右半结肠癌 黏液腺癌 分期 分化 预后 SEER数据库 

分 类 号：R735.35[医药卫生—肿瘤]