基于SEER数据库的胰腺癌患者自杀风险因素分析  

Risk factors for suicide in patients with pancreatic cancer using data from the SEER database

作　　者：黄礼莹 黄韬 李莉[1] 冯敖梓 何宁霞 李淑娜 吕军 Li-Ying HUANG;Tao HUANG;Li LI;Ao-Zi FENG;Ning-Xia HE;Shu-Na LI;Jun LYU(Department of Clinical Research,The First Affiliated Hospital of Jinan University,Guangzhou 510630,China)

机构地区：[1]暨南大学附属第一医院临床研究部,广州510630

出　　处：《医学新知》2022年第3期192-200,共9页New Medicine

基　　金：国家社会科学基金项目(16BGL183)。

摘　　要：目的 探讨胰腺癌患者自杀的风险因素。方法 利用SEER(Surveillance,Epidemiology,and End Results)Research Plus数据库筛选1975—2018年胰腺癌患者,描述自杀死亡者、非自杀死亡者和存活者的分布特征,计算人年自杀率、标准化死亡比并分析相应群体特点。使用回归分析探索胰腺癌患者自杀的风险因素,并进一步分析男性患者的自杀风险因素。结果 153 612例胰腺癌患者中,白色人种(80.68%)、65岁及以上(65.02%)、不建议手术(70.57%)、肿瘤远处转移(57.28%)、已婚(56.06%)、家庭年收入中位数在50 000~74 999美元(47.17%)、未采取化疗(52.48%)的患者群体占比较高,且与138名胰腺癌自杀患者的群体特征分布相似。回归分析结果显示,男性[aRR=12.81,95%CI (6.85,23.96),P <0.001]、白色人种[aRR=3.56,95%CI(1.43,8.85),P=0.006]、诊断年龄为65岁及以上[aRR=1.55,95%CI(1.07,2.26),P=0.022]、不建议手术[aRR=2.06,95%CI(1.23,3.44),P=0.006]、建议但未采取手术[aRR=2.86,95%CI(1.37,5.98),P=0.005]的患者具有更高的自杀风险,而肿瘤区域转移[aRR=0.56,95%CI(0.37,0.85),P=0.006]和局部转移[aRR=0.44,95%CI(0.23,0.86),P=0.015]、已婚[aRR=0.57,95%CI(0.40,0.82),P=0.002]、化疗[aRR=0.34,95%CI(0.23,0.51),P <0.001]的患者自杀风险相对较低。男性胰腺癌患者的自杀风险显著高于女性患者,不同种族、手术选择、婚姻状态及化疗选择的男性胰腺癌患者,自杀风险具有显著差异。结论 性别、种族、诊断年龄、是否采取手术治疗、SEER阶段、婚姻状态及化疗选择是胰腺癌患者自杀的重要风险因素。对于男性、白色人种、诊断年龄为65岁及以上、不建议手术或建议但未采取手术治疗、肿瘤处于远处转移阶段、单身、未采取化疗的胰腺癌患者需加强识别、干预和护理。Objective To explore risk factors for suicide in patients with pancreatic cancer.Methods The SEER Research Plus database(Surveillance,Epidemiology,and End Results) was searched from 1975 to 2018 for patients with pancreatic cancer.The characteristics and distribution of suicidal and non-suicidal death and cancer survivors were described.The person-year mortality rate from suicide and standard mortality ratio were calculated to analyze characteristics of corresponding groups.Regression analysis was used to investigate risk factors for suicide in patients with pancreatic cancer,with further analysis of male patients having risk factors associated with suicide.Results The proportions of patients with characteristics of Caucasian(80.68%),up to 65 years old(65.02%),surgery not recommended(70.57%),neoplasm with distant metastasis(57.28%),married(56.06%),median annual household income between 50,000 to 74,999 dollars(47.17%) and no chemotherapy(52.48%) were relatively high in 153,612 patients with pancreatic cancer,which was similar to the stratified population distribution of characteristics of 138 patients with pancreatic cancer who committed suicide.The results of Poisson regression analysis showed that male [aRR=12.81,95%CI(6.85,23.96),P<0.001],Caucasian [aRR=3.56,95%CI(1.43,8.85),P=0.006],up to 65 years old [aRR=1.55,95%CI(1.07,2.26),P=0.022],surgery not recommended [aRR=2.06,95%CI(1.23,3.44),P=0.006],surgery recommended but not undertaken [aRR=2.86,95%CI(1.37,5.98),P=0.005] had a higher risk of suicide;while tumor regional metastasis [aRR=0.56,95%CI(0.37,0.85),P=0.006] and local metastasis [aRR=0.44,95%CI(0.23,0.86),P=0.015],married [aRR=0.57,95%CI(0.40,0.82),P=0.002],chemotherapy [aRR=0.34,95%CI(0.23,0.51),P<0.001] have a relatively low risk of suicide.The suicide risk of male patients with pancreatic cancer is significantly higher than that of female patients.The risk of suicide among male patients with pancreatic cancer showed significant differences between different races,surgical options,marital status,and c

关 键 词：胰腺癌 自杀 SEER数据库 风险因素 

分 类 号：R735.9[医药卫生—肿瘤]