结直肠癌预后相关因素配合时协变量的COX回归分析

COX regression analysis of factors affect prognosis of colorectal cancer with time covariate

目的:研究结直肠癌的生存情况及影响因素,为临床预后的判断提供依据。方法:选择血清肿瘤标志物、肿瘤部位、DUCKS分期、等11项相关临床病生理指标,用SAS 9.2软件对598例结直肠癌患者进行单因素Kaplan-meier和多因素非比例风险的COX模型配合分析。结果:598例结直肠癌患者1年、3年、5年的生存率分别为91.79%、56.14%、21.89%,其中DUCK分期A期、B期、C期、D期患者5年生存率依次递减,分别为56.52%、29.81%、16.49%、8.98%;50%以上淋巴转移比50%以下淋巴转移患者5年生存率低约4%～5%,比无淋巴转移患者的5年生存率约低20%～21%。年龄为保护性影响因素,随着年龄的增加,结直肠癌患者的死亡风险减小0.0008倍。对上述各因素进行生存曲线比较(K-M法),差异均有统计学意义(均P<0.05)。结论:多因素分析结果显示,肿瘤的ducks分期、年龄、病理诊断、血清中癌胚抗原CEA的含量及糖链抗原是结肠癌生存预后的影响因素。

Objective：To study the survival status of colorectal cancer patients and related factors of prognosis.Methods：Serum tumor markers,tumor location,DUCKS stage,and other 11 related physiological indicators of 598 colorectal cancer patients were determined and analyzed by univariate Kaplan-meier survival analysis and multivariate COX proportional hazards model analysis.Results：1,3,5-year survival rates were 91.79%,56.14%,21.89%,respectively,and the 5-year survival rate of patients was 56.52%,29.81%,16.49%,8.98% at DUCK staging A,B,C and D,respectively.Patients with 50% or more lymph node metastasis had 4%-5% lower 5-year survival rate than patients with 50% lymph node metastasis,and 20%-21% lower than those without lymph node metastasis.Age was protective factor,and the risk of death due to colorectal cancer was decreased by 0.0008 times with aging.K-M method analysis revealed that the differences in various factors were statistically significant（P〈0.05）.Conclusions： Multivariate analysis reveals that the ducks stage,age,pathological diagnosis,CEA and ca242 are influential factors of colorectal cancer.