结直肠癌患者职业与长期预后的关系:基于DACCA数据库的真实世界分析  

Relation between occupation and long-term prognosis in patients with colorectal cancer:a real-world study based on DACCA database

作　　者：廖伟豪 李澔 吴桂儀 周凡琳 汪晓东[1] 李立[3] LIAO Weihao;LI Hao;WU Guiyi;ZHOU Fanlin;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;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》2024年第11期1385-1390,共6页Chinese Journal of Bases and Clinics In General Surgery

基　　金：四川大学大学生创新创业训练计划项目(项目编号:C2024130021)。

摘　　要：目的 基于四川大学华西医院的肠癌数据库(Database from Colorectal Cancer,DACCA)探索结直肠癌患者职业与长期预后的关系。方法 采用2022年6月29日更新的DACCA数据库数据,参考中国有关规范性文件中的职业划分将患者分为脑力劳动职业组(简称“脑力组”)和体力劳动职业组(简称“体力组”),比较2组患者的总生存和疾病特异性生存情况,再按pTNM分期进行亚组分析。结果 按筛选标准从DACCA数据库中共纳入数据1 974条数据(1 974例患者),其中脑力组349例,体力组1 625例。脑力组的5年累积总生存率(92.1%比84.5%,P<0.001)和疾病特异性生存率(92.1%比85.8%,P=0.002)、10年累积总生存率(72.4%比55.2%,P<0.001)和疾病特异性生存率(75.4%比59.1%,P<0.001)均较体力组更高。按pTNM分期分层分析发现,在pTNM分期Ⅲ期患者中,脑力组的5年和10年累积总生存率(94.0%比82.3%,P<0.001;67.1%比43.7%,P=0.014)、5年和10年累积疾病特异性生存率(94.0%比83.5%,P=0.001;69.5%比47.9%,P=0.026)均较体力组更高;在pTNM分期Ⅱ期患者中,脑力组的10年累积疾病特异性生存率(93.5%比78.7%,P=0.009)较体力组更高。结论 从本研究分析结果看,结直肠癌患者职业与长期预后可能有一定的关系,总体趋势是脑力劳动职业患者相较于体力劳动职业患者长期预后可能更好,而这种差异在pTNM分期Ⅱ期和Ⅲ期患者中相对更明显。Objective To understand the relation between the occupation and long-term prognosis of the patients with colorectal cancer(CRC)based on the Database from Colorectal Cancer(DACCA).Methods The selected updated DACCA database as of June 29,2022 was used for this study.The included patients were assigned into intellectual occupations group(intellectual group)and manual occupations group(manual group)referring to relevant regulatory documents in China.The survival status of the intellectual group and the manual group was compared,and then were stratified by pTNM stage.Results A total of 1974 patients were included from the DACCA database according to the selection criteria,349 of whom in the intellectual group and 1625 of whom in the manual group.The intellectual group had higher 5-year cumulative overall survival rate(92.1%vs.84.5%,P<0.001)and disease-specific survival rate(92.1%vs.85.8%,P=0.002),as well as higher 10-year cumulative overall survival rate(72.4%vs.55.2%,P<0.001)and disease-specific survival rate(75.4%vs.59.1%,P<0.001)compared to the manual group.The stratified analysis by pTNM stage found that,for the patients with pTNMⅢstage,the 5-and 10-year cumulative overall survival rates of the intellectual group were higher than those of the manual group (94.0% vs. 82.3%, P<0.001;67.1% vs. 43.7%, P=0.014), simultaneous the 5- and 10-year cumulative disease-specific survival rates were the same as the overall survival rate (94.0% vs. 83.5%, P=0.001;69.5%vs. 47.9%, P=0.026). Furthermore for the the patients with pTNM Ⅱ stage , it was found that the the 10-year cumulativedisease-specific survival rate of the intellectual group was higher than that of the manual group (93.5% vs. 78.7%,P=0.009).Conclusions From the analysis results of this study, occupation might be related to long-term prognosis inCRC cancer patients. A general trend is that the long-term prognosis of patients with intellectual occupations might bebetter than that of patients with manual occupations, and this difference might be relatively marke

关 键 词：结直肠癌 职业 病理TNM分期 肠癌数据库 总生存 疾病特异性生存 

分 类 号：R735.34[医药卫生—肿瘤]