手术治疗对胆囊鳞状细胞癌预后的影响  

Effect of surgical treatment on prognosis in patients with gallbladder squamous cell carcinoma

作　　者：黄坤 赵攀[1] 赵平武[1] 何运胜 HUANG Kun;ZHAO Pan;ZHAO Pingwu;HE Yunsheng(Department of General Surgery,Mianyang Traditional Chinese Medicine Hospital,Mianyang,Sichuan 621000,P.R.China)

机构地区：[1]绵阳市中医医院普外科,四川绵阳621000

出　　处：《中国普外基础与临床杂志》2023年第8期964-969,共6页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的本研究通过SEER数据库中的大样本真实世界数据,探讨手术治疗对胆囊鳞状细胞癌(gallbladder squamous cell carcinoma,GSCC)患者预后的影响。方法提取SEER数据库中2000–2019年期间经病理确诊的257例GSCC患者的临床资料,依据是否接受手术将患者划分为手术组和非手术组,比较2组间肿瘤特异生存(cancer-specific survival,CSS)和总生存(overall survival,OS)的差异,并进一步采用Cox比例风险回归模型探索CSS与OS的影响因素。结果257例患者中,手术组127例(49.4%),非手术组130例(50.6%)。随访时间0~220个月,中位随访时间为3个月。随访期间,手术组127例中,死亡105例(82.7%),其中肿瘤相关性死亡88例(69.3%);非手术组130例中,死亡124例(95.4%),其中肿瘤相关性死亡115例(88.5%)。手术组和非手术组的中位OS分别为6个月和3个月,估算的1年OS分别为30.1%和4.6%;手术组和非手术组的中位CSS分别为7个月和3个月,估算的1年CSS分别为35.1%和5.8%。log-rank检验结果显示手术组和非手术组的OS和CSS比较差异均有统计学意义(χ^(2)=41.400,P<0.001;χ^(2)=42.750,P<0.001)。多因素Cox比例风险回归结果显示,手术治疗能提高GSCC患者的OS[HR=0.44,95%CI(0.25,0.77),P=0.004]和CSS[HR=0.46,95%CI(0.25,0.84),P=0.011]。结论手术治疗是GSCC预后的影响因素,R0切除能使GSCC患者明显获益。Objective To evaluate the prognostic value of surgical treatment in gallbladder squamous cell carcinoma(GSCC)by using real-world data with a large sample in the Surveillance,Epidemiology and End Results(SEER)database.Methods The clinical data of patients with pathologically diagnosed GSCC from 2000 to 2019 were extracted from the SEER database.According to the inclusion and exclusion criteria,a total of 257 patients were included after strict screening.The patients were divided into operation group and non-operation group according to whether they underwent surgery.The cancer-specific survival(CSS)and the overall survival(OS)between the two groups were compared,and the influencing factors for the CSS and the OS were analyzed by using Cox proportional hazard model.Results Of 257 patients,127(49.4%)were in the operation group,and 130(50.6%)in the non-operation group.The average follow-up ranged from 0 to 220 months,with the median follow-up time of 3 months.Of the 127 patients in the operation group,105 died(82.7%),including 88 tumor-related deaths(69.3%).Of the 130 patients in the non-operation group,124 died(95.4%),including 115 tumor-related deaths(88.5%).The median survival time for OS in the operation group and the non-operation group were 6 months and 3 months,respectively,and that for CSS were 7 months and 3 months,respectively.The estimated 1-year OS of the operation group and the non-operation group were 30.1%and 4.6%respectively;the estimated 1-year CSS were 35.1%and 5.8%,respectively.There were significant differences between the two groups on OS and CSS(χ^(2)=41.400,P<0.001;χ^(2)=42.750,P<0.001).That the OS[HR=0.44,95%CI(0.25,0.77),P=0.004]and the CSS[HR=0.46,95%CI(0.25,0.84),P=0.011]in GSCC patients were significantly improved by surgical treatment,showed by the results of multivariate prognostic analysis via Cox proportional hazard mode.Conclusions Surgical treatment was an independent factor affecting the prognosis of GSCC,and it could improve the OS and the CSS.As for the modus operandi,R0 resecti

关 键 词：胆囊鳞状细胞癌 手术治疗 预后 SEER数据库 

分 类 号：R735.8[医药卫生—肿瘤]