结直肠癌患者婚姻状态与术后病理分期的关系:基于DACCA的真实世界数据研究  

Relation between marital status and postoperative pathological stage in patients with colorectal cancer:a real-world data study based on DACCA

作　　者：黄靖婷 岑月妍 祁禹晗 卢美艳 汪晓东[1,2] 李立[4] HUANG Jingting;CEN Yueyan;QI Yuhan;LU Meiyan;WANG Xiaodong;LI Li(Division of Gastrointestinal Surgery,Department of General Surgery,West China Hospital,Sichuan University,Chengdu 610041,P.R.China;West China School of Medicine,Sichuan University,Chengdu 610041,P.R.China;West China College of Stomatology,Sichuan University,Chengdu 610041,P.R.China;Colorectal Cancer Center,West China Hospital,Sichuan University,Chengdu 610041,P.R.China)

机构地区：[1]四川大学华西医院普通外科,胃肠外科病房,成都610041 [2]四川大学华西临床医学院,成都610041 [3]四川大学华西口腔医学院,成都610041 [4]四川大学华西医院结直肠肿瘤中心,成都610041

出　　处：《中国普外基础与临床杂志》2023年第7期782-787,共6页Chinese Journal of Bases and Clinics In General Surgery

基　　金：四川省科技计划项目重点研发项目(项目编号:2021YFS0112)。

摘　　要：目的分析当前版本华西肠癌数据库(Database from Colorectal Cancer,DACCA)中不同婚姻状态结直肠癌患者术后病理分期特征是否有差异。方法根据制定的筛选条件从2023年1月23日更新版DACCA中收集患者并按婚姻状态分为已婚、未婚、丧偶或离异3种状态,分析处于这3种婚姻状态的结直肠癌患者在术后病理分期、周围神经受累和病理肿瘤退缩分级、癌结节及高危因素方面的差异。结果共收集到符合筛选条件的数据6947条,其中未婚113条(1.6%)、已婚6315条(90.9%)、离异或丧偶519条(7.5%)。3种婚姻状态的结直肠癌患者在病理TNM分期[Ⅰ~Ⅳ期总体比较:H=19.030、P<0.001;分期早(Ⅰ+Ⅱ期)和分期晚(Ⅲ+Ⅳ期)比较:χ^(2)=19.124、P<0.001]、病理T分期(H=7.147、P=0.028)和高危因素分级(H=10.246、P=0.006)方面总体比较差异均有统计学意义,呈现出的趋势是,病理TNM分期(Ⅰ期)和病理T分期(T1期)较早期者占比在3种婚姻状态的已婚患者中最高,分期最晚者(Ⅳ期、T4期)占比在已婚患者中最低,高危因素分级呈现出同样的趋势,而未发现3种婚姻状态的结直肠癌患者在其他病理特征如周围神经受累、病理肿瘤退缩分级及癌结节方面差异呈现出统计学意义(P>0.05)。结论通过DACCA中的数据分析发现,不同婚姻状态结直肠癌患者的术后病理分期特征呈现出一定的差异,尤其是病理TNM分期、病理T分期和高危因素分级方面,但对此结论需客观看待,从统计学角度,本研究中3种婚姻状态患者的样本量差异较大,今后可在此基础上平衡样本量后进一步分析;从临床角度,受影响的因素可能更多,需逐一排除混杂干扰因素后客观分析。Objective To analyze differences in postoperative pathological stage characteristics of colorectal cancer(CRC)patients with different marital status in Database from Colorectal Cancer(DACCA).Methods According to the established screening conditions,the patients were collected from the updated version of DACCA on January 23,2023,and then assigned into three categories according to marital status:married,unmarried,widowed or divorced patients.The differences in postoperative pathological staging,peripheral nerve involvement,pathological tumor regression grade(TRG),cancer nodules,and high-risk factors among the CRC patients with different marital statuses were analyzed.Results A total of 6947 data matching the screening criteria were collected,including 113 unmarried patients(1.6%),6315 married patients(90.9%),and 519 divorced or widowed patients(7.5%).The analysis results showed that the pathological TNM staging(Ⅰ–Ⅳstaging:H=19.030,P<0.001;Ⅰ+ⅡandⅢ+Ⅳstaging:χ^(2)=19.124,P<0.001),pathological T staging(H=7.147,P=0.028),and high-risk factors grading(H=10.246,P=0.006)had statistical differences.The trend presented that the proportions of the patients with earlier pathological TNM staging and T staging(Ⅰor T1 staging)in the married patients were the highest among the 3 marital statuses patients,and the proportions of the later staging(Ⅳor T4 staging)were the lowest in the married patients.The same trend was found in the high-risk factors grading.However,there were no statistical differences in other pathological features such as peripheral nerve involvement,pathological TRG,and cancer nodules among the CRC patients with 3 marital statuses(P>0.05).Conclusions Through data analysis in DACCA,it is found that CRC patients with different marital statuses exhibit certain differences in postoperative pathological stage characteristics,especially in terms of pathological TNM staging,pathological T staging,and high-risk factor grading.However,this conclusion needs to be objectively regarded.From a statistical

关 键 词：婚姻状态 结直肠癌 术后病理 华西肠癌数据库 

分 类 号：R735.34[医药卫生—肿瘤]