1991例以医院为基础的胃癌双向性队列研究患者生存分析  

Survival Analysis of Patients with Gastric Cancer:A Hospital-Based Bidirectional Cohort Study

作　　者：徐辉 吴志军[3] 张澄 张小鹏[4] 凤翀[4] 冯颖 谢敏敏 杨雅慧 张毅[2] 马泰[2] XU Hui;WU Zhijun;ZHANG Cheng;ZHANG Xiaopeng;FENG Chong;FENG Ying;XIE Minmin;YANG Yahui;ZHANG Yi;MA Tai(Anhui Provincial Cancer Institute/Anhui Provincial Office for Cancer Prevention and Control,Hefei 230022,China;The First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Ma’anshan People’s Hospital,Ma’anshan 243000,China;Hefei Center for Disease Control and Prevention,Hefei 230091,China)

机构地区：[1]安徽省肿瘤防治所/安徽省肿瘤防治办公室,安徽合肥230022 [2]安徽医科大学第一附属医院,安徽合肥230022 [3]马鞍山市人民医院,安徽马鞍山243000 [4]合肥市疾病预防控制中心,安徽合肥230091

出　　处：《肿瘤学杂志》2023年第10期847-852,共6页Journal of Chinese Oncology

基　　金：安徽省重点研究与开发计划项目(1804b06020351);安徽医科大学第一附属医院临床研究项目(LCYJ2021YB015);安徽医科大学校基金资助项目(2022xkj160)。

摘　　要：[目的]分析安徽医科大学第一附属医院2008年3月至2021年8月胃癌住院治疗患者的生存率,为胃癌综合防治策略提供依据。[方法]于2018年建立以医院为基础的胃癌双向性队列研究数据库,采用主动随访与被动随访结合的方式获取患者生存信息。用Kaplan-Meier法计算生存率并绘制生存曲线,采用反式Kaplan-Meier法计算中位随访时间,单因素分析采用Log-rank检验。[结果]1991例胃癌患者男女比例为2.51∶1,平均发病年龄(60.60±11.30)岁,整体中位生存时间18.20个月(95%CI:17.10~19.70),随访率97.99%,失访率2.01%。50岁以上病例数明显增多,60~69岁年龄组病例最多,50~79岁的病例占80.01%。胃癌患者的1年、3年、5年、10年观察生存率分别为65.46%、25.77%、14.87%、8.49%。40~49岁年龄组患者生存率最高,随着诊断年龄的提高,生存率总体上呈现逐渐降低趋势(χ^(2)=73.00,P<0.01)。低分化组病例最多(61.98%),中分化组生存率最高(χ^(2)=96.10,P<0.01);腺癌病例最多(90.86%),生存率最高(χ^(2)=24.80,P<0.01);TNM分期Ⅰ期患者生存率最高,Ⅱ期、Ⅲ期、Ⅳ期患者生存率逐渐降低(χ^(2)=743.00,P<0.01);不同性别患者生存率差异无统计学意义(P>0.05)。[结论]胃癌患者的生存率偏低,应重点关注年龄、分化程度、病理类型和TNM分期对预后的影响,加强胃癌的早期筛查和规范化诊疗,提高患者生存率。[Objective]To analyzed the survival of hospitalized patients with gastric cancer.[Methods]A hospital-based bidirectional cohort study database was established among patients with gastric cancer admitted in the First Affiliated Hos-pital of Anhui Medical University from March 2008 to August 2021.The survival information of patients was obtained by combining active and passive follow-up.Kaplan-Meier method was used to calculate the survival rate and to draw the sur-vival curve,and the inverse Kaplan-Meier method was used to calculate the median follow-up time.Log-rank test was used for univariate analysis.[Results]The data of 1991 patients with gastric cancer were collected,with a male to fe-male ratio of 2.51∶1 and a mean onset age of(60.60±11.30)years old.The overall median survival time was 18.20 months(95%CI:17.10~19.70),the follow-up rate was 97.99%,and the lost follow-up rate was 2.01%.Most patients were in the age group of 60 to 69 years old,and patients aged 50 to 79 years old accounted for 80.01%of all cases.The 1-year,3-year,5-year and 10-year observed overall survival(OS)rates were 65.46%,25.77%,14.87%and 8.49%,respectively.The sur-vival rate of patients aged 40~49 years old was the highest.With the increase of diagnosis age,the survival rate showed a decreasing trend(χ^(2)=73.00,P<0.001).Patients with poorly differentiated gastric cancer accounted for 61.98%,while pa-tients with moderately differentiated disease had the highest survival rate(χ^(2)=96.10,P<0.01).Patients with adenocarcinoma had the highest proportion(90.86%)in all pathological types and they had the highest survival rate(χ^(2)=24.80,P<0.01).The survival rate of TNM stageⅠwas the highest,followed by TNM stageⅡ,ⅢandⅣ(χ^(2)=743.00,P<0.01).There was no significant difference in survival rate between male and female patients(P>0.05).[Conclusion]The survival rate of gastric cancer patients is relatively low.Age,tumor differentiation,pathological type and TNM stage have impact on survival and prognosis of patients.Early screening

关 键 词：胃肿瘤 肿瘤登记/以医院为基础 生存随访 生存率 

分 类 号：R735.2[医药卫生—肿瘤]