摘要
背景宁夏地处我国西北,是我国胃癌(gastric cancer,GC)的高发区,GC位于宁夏地区恶性肿瘤死亡原因首位.但目前关于宁夏地区GC患者流行现状、分布特征及预后的大样本量的流行病学资料非常有限.目的回顾性分析5022例宁夏籍GC住院患者的临床病理资料,了解宁夏地区GC流行现状,明确影响其预后的独立危险因素.方法收集2009年至2017年在宁夏医科大学总医院住院治疗的5022例宁夏籍GC患者的临床病理资料及预后生存信息.以患者确诊日期为观察起点,以因GC死亡日期为观察终点,随访截止日期为2019-01-24,建立数据库.一般人口学资料及临床病理资料描述用率表示.Kaplan-Meier法计算中位生存时间,生存分析组间比较用log-rank法,Cox比例风险模型分析GC患者预后影响因素.通过计算危险比和95%CI计算相对风险.分析GC在该地区的流行现状,明确影响其预后的主要危险因素.结果5022例宁夏籍GC患者中,男性3888例(77.4%),女性1134例(22.6%),男女比为3.43:1,年龄范围为15-93岁,中位年龄为61(15)岁;1734例患者因GC死亡,死亡率为34.5%.GC患者死亡率随年龄增加呈增长的趋势;单因素生存分析显示,年龄、肿瘤(Tumor-Node-Metastasis,TNM)分期、肿瘤位置、大小、分化程度等是宁夏籍GC患者预后的独立危险因素,手术和术后放化疗是其保护因素;Cox生存分析显示,年龄、TNM分期、肿瘤位置、大小、分化程度均是GC患者预后的危险因素,手术和术后放化疗是其保护因素(P<0.01).结论宁夏地区GC患者以男性和老年患者为主;宁夏地区GC患者整体死亡率较高,预后较差;年龄、TNM分期、肿瘤位置等均是该地区GC患者预后的独立危险因素,手术和术后放化疗是其保护因素.
BACKGROUND Ningxia is located in the northwest of China,which is a high incidence area of gastric cancer(GC),and GC is the top cause of malignancy related death in this area.However,epidemiological data on the prevalence and prognosis of GC in Ningxia are very limited.AIM To retrospectively analyze the clinicopathologic features of 5022 patients with GC in Ningxia to understand the epidemiological characteristics and identify prognostic risk factors in patients with GC.METHODS A total of 5022 hospitalized GC patients from January 2009 to December 2017 were involved.Clinicopathologic data and survival status were collected.Overall survival(OS)was calculated from the time of initial diagnosis to either the date of death due to GC or the last follow-up date.OS was generated by the Kaplan-Meier method,and the differences between subgroups were compared using the log-rank test.Multivariate analysis was performed with estimated by calculating hazard ratios and 95%CI.The prevalence of GC in this area was then analyzed,and the main risk factors affecting its prognosis were identified.RESULTS Among the 5022 cases of GC in Ningxia,3888(77.4%)were male and 1134(22.6%)were female,with a maleto-female ratio of 3.43:1.The patients ranged in age from 15-93 years,with a median age of 61(15)years.Totally,1734 patients died of GC,with a mortality rate of 34.5%.The mortality rate of patients with GC increased with age.Multivariate survival analysis showed that age,Tumor-Node-Metastasis(TNM)stage,tumor location,tumor size,and tumor differentiation were independent risk factors for the prognosis of GC patients in Ningxia,and surgery and postoperative radiochemotherapy were protective factors.CONCLUSION The majority of GC patients in Ningxia are elderly men.The overall mortality rate of GC patients in Ningxia is high and the prognosis is poor.Age,TNM stage,and tumor location are independent risk factors for prognosis of GC patients in this region,and surgery and postoperative chemoradiotherapy are protective factors.
作者
曹娟
王冠华
伍静
赵丹
王文凡
张晓旭
阮继刚
杨文君
Juan Cao;Guan-Hua Wang;Jing Wu;Dan Zhao;Wen-FanWang;Xiao-Xu Zhang;Ji-Gang Ruan;Wen-Jun Yang(Key Laboratory of Environmental Health and Chronic Disease Prevention and Control,School of Public Health and Management,Ningxia Medical University,Yinchuan 750004,Ningxia Hui Autonomous Region,China;Department of Cardio-Thoracic Surgery,the General Hospital of Ningxia Medical University,Yinchuan 750002,Ningxia Hui Autonomous Region,China;Department of Gastroenterology,the General Hospital of Ningxia Medical University,Yinchuan 750004,Ningxia Hui Autonomous Region,China;Key laboratory of Fertility Preservation and Maintenance(Ministry of Education),Ningxia Medical University,Yinchuan 750004,Ningxia Hui Autonomous Region,China)
出处
《世界华人消化杂志》
CAS
2020年第19期964-971,共8页
World Chinese Journal of Digestology
基金
国家自然科学基金资助项目,No.81760525。
关键词
胃癌
预后
生存
危险因素
Gastric cancer
Prognosis
Survival
Risk factor
