上海市徐汇区原发性肝癌患者随访队列生存分析

Survival Analysis on a Follow-up Data of Patients with Primary Liver Cancer in Xuhui District of Shanghai

目的了解原发性肝癌患者发病及生存情况,为今后的筛查和干预工作提供依据。方法对上海市徐汇区2001—2004年新发的652名原发性肝癌患者队列随访资料进行分析,描述发病年龄分布,建立Cox比例风险模型,分析生存率的主要影响因素。结果原发性肝癌发病年龄构成呈双峰分布,第1个发病高峰在45～50岁,第2个发病高峰在70～75岁。652名患者中位生存时间为6.9个月。接受手术治疗的患者较未手术患者死亡风险降低(RR=0.315 5,95%CI为0.243 2～0.409 3),手术患者5a累积生存率为40.90%,未手术患者5a累积生存率仅3.95%。性别、年龄、家族史等因素对生存率的影响无统计学意义(P>0.05)。结论原发性肝癌的筛查和干预工作重点应放在高危人群发病年龄高峰之前,早发现并有手术指征的患者应尽量实施手术治疗,以提高患者生存率。

Objective To investigate the survival rates in a follow-up group of patient with primary liver cancer. Methods The follow-up data of new primary liver cancer cases between year 2001 -2004 in Xuhui district was investigated. The age distribution of patients was described. Survival rate was analyzed with single and multiple Cox proportional hazards regression model, respectively. Results The age proportion distribution of patients showed double apexes with one in age 45-50 and another in age 70-75. The arithmetic mean of survival month was 16.4 with 95%CI 14.8-18.1 and median month was 6.9. It was no significance between male and female. Patients who had liver operation owned longer survival time, RR=0.315 5 （95%CI 0.243 2- 0.409 3）. The sutdy showed 5-year survival rate was 40.90% and 3.95% for patients with or without operation, respectively. It had no significant effect on survival time by gender, age and family history. Conclusion The screening test and intervention in high-risk people shall be done preferentially before peak age, so as to find primary liver cancer earlier, and the more patients can accept a suitable surgery care, the more they can obtain longer survival time.