基于人群数据来源的辽宁省胰腺癌患者长期生存分析  

Long-term Survival Analysis of Pancreatic Cancer Patients from 2000 to 2002 in Liaoning Province:a Population-based Study

作　　者：张蕊 徐绍和[3] 安晓霞[4] 李恂[5] 刘莉[2] 于丽娅[2] 穆慧娟[2] 于飞[6] 潘国伟[6] 礼彦侠 Zhang Rui;Xu Shaohe;An Xiaoxia(College of Public Health,Shanghai University of Medicine and Health Sciences(201318),Shanghai)

机构地区：[1]上海健康医学院健康与公共卫生学院,201318 [2]辽宁省疾病预防控制中心慢性非传染性疾病预防控制所 [3]鞍山市疾病预防控制中心 [4]本溪市疾病预防控制中心 [5]沈阳市疾病预防控制中心 [6]中国医科大学公共卫生学院全民健康研究室

出　　处：《中国卫生统计》2022年第6期839-843,共5页Chinese Journal of Health Statistics

基　　金：辽宁省“兴辽英才计划”项目资助(XLYC1802131)。

摘　　要：目的通过分析辽宁省胰腺癌患者10年生存率情况,为制定和评估防治策略和措施,提高胰腺癌患者预后提供数据支持。方法随机选取2000-2002年沈阳、鞍山和本溪3市肿瘤发病数据库中胰腺癌患者,进行被动结合主动随访,应用寿命表法和EdererⅡ法计算观察生存率(observed survival rate,OSR)、中位生存时间(median survival time,T 50)、相对生存率(relative survival rate,RSR)。通过Kaplan-Meier分析、log-rank检验、Z检验、Brown氏比分检验比较不同特征患者T 50、OSR、RSR的差异。采用Cox比例风险模型估计各因素的风险比。结果共514例胰腺癌患者纳入分析,T 50为(4.6±0.3)月,10年OSR为(3.7%±0.8%),RSR为(5.0%±1.1%)。男性和女性10年RSR分别为4.2%和6.0%,<65岁组、65~74岁组、≥75岁组分别为5.5%、5.9%、2.3%,诊断分期Ⅰ~Ⅱ期、Ⅲ期、Ⅳ期分别为18.5%、5.0%、1.4%,手术组和非手术组分别为5.4%和5.2%。男性和女性间RSR曲线无统计学差异(χ^(2)=3.163,P>0.05);≥75岁组RSR显著低于<65岁组(χ^(2)=8.660,P<0.05),≥75岁组与65~74岁组间(χ^(2)=3.208,P>0.05)、<65岁组和65~74岁组间(χ^(2)=2.302,P>0.05)无统计学差异;诊断分期Ⅰ~Ⅱ期组、Ⅲ期组、Ⅳ期组间RSR均具有统计学差异(χ^(2)分别为6.515、30.455、7.007,P<0.05),分期越高,RSR越低;非手术组10年RSR显著低于手术组(χ^(2)=34.032,P<0.05)。但手术治疗导致生存率的获益第二年之后不再显著。结论年龄越大、诊断分期越高、非手术治疗方式患者的RSR越低。手术治疗导致生存率的获益随着时间的推移不再显著。Objective To analyze the 10-year survival rate of pancreatic cancer patients in Liaoning Province,and to provide data support for formulating and evaluating prevention strategies and measures.Methods From 2000 to 2002,patients with pancreatic cancer in Shenyang,Anshan and Benxi were randomly sampled in the tumor database,and passive combined with active follow-up was performed,the observed survival rate(OSR)、median survival time(T 50)and the relative survival rate(RSR)were calculated by using the life table method and Ederer II method.Kaplan-Meier analysis,log-rank test,Z test,Brown′s score test were used to compare the differences of T 50,OSR and RSR among patients with different characteristics.Cox proportional hazard model was used to estimate the risk ratio of each factor.Results A total of 514 patients with pancreatic cancer were included in the analysis.T 50 was(4.6±0.3)months,10-year OSR was(3.7%±0.8%),and RSR was(5.0%±1.1%).The 10-year RSR of males and females was 4.2%and 6.0%,<65 years old,65~74 years old,and≥75 years old were 5.5%,5.9%,2.3%,the diagnosis stagesⅠ~Ⅱ,Ⅲ,Ⅳwere 18.5%,5.0%,1.4%,the surgical and non-surgical groups were 5.4%and 5.2%,respectively.There was no statistically significant difference in RSR curves between men and women(χ^(2)=3.163,P>0.05);the RSR of≥75 years old group was significantly lower than<65 years old group(χ^(2)=8.660,P<0.05).There was a statistically significant difference in RSR among stageⅠ~Ⅱ,Ⅲ,Ⅳ(χ^(2)were 6.515,30.455,7.007,respectively,P<0.05).The higher the stage,the lower the RSR.The non-surgical group was significantly lower than that of the surgical group(χ^(2)=34.032,P<0.05).But the benefit of surgical treatment resulting in survival rate is no longer significant after second year.Conclusion The older age,the higher diagnosis stage,and the non-surgical treatment patients had lower RSR.Surgical treatment results in survival benefits that are no longer significant over time.

关 键 词：观察生存率 相对生存率 胰腺癌 长期 

分 类 号：R735.9[医药卫生—肿瘤]