影响胃癌手术后生存因素的Cox模型分析

ANALYSIS BY COX REGRESSION MODELS OF THE PROGNOSTIC FACTORS IN POST- OPERATIVE GASTRIC CANCER

用Ｃｏｘ回归模型对１０１例胃癌手术患者的预后进行单因素和多因素分析。从３０项指标中筛选出对生存时间影响显著的５个因素。按其对生存时间的作用大小排列：根治性手术；术后化疗；淋巴结转移；肿瘤浸润深度及大便潜血。其中，根治性手术和术后化疗是保护性因子，能延长生存时间。其余之项则为危险因子，可缩短生存时间。根据Ｃｏｘ模型分析最终筛选出来的五项显著指标的回归系数，建立胃癌术后生存预测方程：运。用该方程对生存五年以上及生存不足五年而死亡的胃癌手术病人９６例的预后进行预侧，并将预测结果与随访的实际结果进行比较，其敏感性、特异性和符合率分别为８８．２４％，８５４８％和８６．４６％，两者基本符合。

postoperative gastric cancer patients were analysed by Cox regression mod-els to determine the main prognostic factors of gastric cancer after operation,Of the thirtv fac-tors involved in the analystic procedure,five factors were significant.Thev included two protec-tive factors(radical resection amd postoperative adjuvant chemotherapy)and three risky factors(lymph node metastasis,depth oftumor cell infiltration and occult blood in stool).A predictingequation was established,and the predicting values were calculated according to the patients′individual features.The predicting and actual values were compared,and the sensitivity,specificty and overall concordance were 88.24%,85.48% and 86.46% respectively.