基于SEER数据库的腹膜后恶性纤维组织细胞瘤的临床病理特点及预后分析  

Clinicopathological features and prognosis of retroperitoneal malignant fibrous histiocytoma based on SEER database

作　　者：黄坤 赵平武[1] 张业光[2] 王晋[3] 白斗[4] HUANG Kun;ZHAO Ping-wu;ZHANG Ye-guang;WANG Jin;BAI Dou(Department of General Surgery,Mianyang Hospital of Traditional Chinese Medicine,Mianyang 621000,China;Department of Ultrasound,Mianyang Hospital of Traditional Chinese Medicine,Mianyang 621000,China;Department of Oncology,Mianyang Central Hospital,Mianyang 621000,China;Department of Vascular Surgery,Mianyang Central Hospital,Mianyang 621000,China)

机构地区：[1]绵阳市中医医院普外科,四川绵阳621000 [2]绵阳市中医医院超声科,四川绵阳621000 [3]绵阳市中心医院肿瘤科,四川绵阳621000 [4]绵阳市中心医院血管外科,四川绵阳621000

出　　处：《中国现代普通外科进展》2023年第1期41-44,55,共5页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:比较腹膜后恶性纤维组织细胞瘤(MFH)的临床特点,分析影响其预后的独立危险因素。方法:提取美国癌症监测、流行病学和结果(SEER)数据库2000—2018年经病理学确诊并且有完整的随访记录资料的腹膜后恶性肿瘤患者,根据国际疾病分类肿瘤学专辑第三版(ICD-O-3)分类标准,分为MFH和其他类型恶性肿瘤两类,对其临床病理资料进行回顾性分析。采用Kaplan-Meier曲线进行生存分析,并构建Cox回归模型分析探索影响腹膜后MFH患者远期预后的独立影响因素。结果:共纳入4653例腹膜后恶性肿瘤患者,中位随访时间37个月(IQR:13~91个月),其中MFH 118例,中位生存时间20个月。其1年、3年、5年生存率分别为62.83%、34.47%、28.12%;其他类型恶性肿瘤患者4535例,中位生存时间70个月。其1年、3年、5年生存率分别为:80.46%、62.18%、52.88%。Log-rank检验显示,两者间差异有统计学意义(χ^(2)=57.77,P<0.001)。Cox单因素分析显示,在MFH患者组中,仅手术治疗(P<0.001)是影响患者预后的因素;而年龄、性别、种族、放疗、化疗、肿瘤分化程度均不是影响MFH患者预后的因素(均P>0.05)。Cox多因素分析通过调整了年龄、性别、分化程度、化疗对患者的预后影响后,显示手术治疗是患者预后的独立危险因素(P<0.001)。在其他类型恶性肿瘤组中,Cox单因素分析显示,年龄、性别、手术、化疗、肿瘤分化程度与患者预后相关(均P<0.05)。Cox多因素分析显示,年龄、性别、化疗、手术、肿瘤分化程度是影响预后的独立因素(均P<0.05)。结论:MFH是腹膜后恶性肿瘤中发病较少、预后较差的病理学类型,手术治疗是改善患者预后的唯一手段。而其他病理学类型肿瘤中,年龄、性别、化疗、手术、肿瘤分化程度,均是影响患者预后的因素,因此应根据患者的具体情况制定个体化的治疗方案。Objective: To compare the clinical features of retroperitoneal malignant fibrous histiocytoma(MFH) and analyze the independent risk factors affecting its prognosis. Methods: Patients with retroperitoneal malignant tumor and complete follow-up records,confirmed by pathology during 2000-2018 were extracted from Surveillance, Epidemiology, and End Results(SEER)database. According to international classification of diseases for oncology, third edition(ICD-O-3),thepatients was divided into MFH group and other types of malignant tumors group, and the clinicopathological data of the two group were analyzed retrospectively. Kaplan-Meier curve was used for survival analysis, and Cox regression model was established to analyze the independent factors affecting the long-term prognosis. Results: A total of 4653 patients with retroperitoneal malignant tumors were included in the analysis. The median follow-up time was37 months(IQR:13~91months). Of the 4653 patients, 118 patients were MFH group with a median survival time of 20months and the 1-, 3-and 5-year survival rates were 62.83%, 34.47% and 28.12%, respectively;4535 patients were the other types of malignant tumors group with a median survival time of 70months, and the 1-, 3-and 5-year survival rates were 80.46%, 62.18% and 52.88%, respectively.Log-rank test showed that there was significant difference between the two groups(χ~2=57.77). In the MFH group, Univariate and multivariate Cox analysis showed that only surgical treatment was the factor affecting the prognosis(P<0.001), and Age, sex, race, radiotherapy, chemotherapy and tumor differentiation were not the factors affecting the prognosis(all P>0.05);In other types of malignant tumor groups, Univariate analysis showed that age, sex, operation, chemotherapy and tumor differentiation were was associated with the prognosis(all P<0.05);Multivariate Cox analysis showed that age, sex, chemotherapy, surgery and tumor differentiation were independent factors affecting prognosis(all P<0.05). Conclusion: MFH is a pathologica

关 键 词：腹膜后恶性纤维组织细胞瘤 SEER数据库 危险因素 预后 

分 类 号：R735.4[医药卫生—肿瘤]