鼻咽癌住院病例生存分析

Survival Analysis of Inpatients with Nasopharyngeal Carcinoma

目的分析湖南省某三甲医院1992-2005年鼻咽癌住院病例生存情况,为医生制订最佳治疗方案和鼻咽癌防控措施提供科学依据。方法收集湖南省某三甲医院1992-2005年鼻咽癌住院病例生存资料,采用SPSS 15.0和Excel 2003软件进行统计学分析。结果随访湖南省某三甲医院1992-2005年鼻咽癌住院病例4 600例,随访截止时间为2010年12月31日,其中生存1 740例,因本病死亡2 819例,因其他原因死亡12例,中途失访24例,完全失访5例,随访应答率99.89%,数据删失率38.65%。1年生存率为93.47%,3年生存率为76.50%,5年生存率为62.69%,10年生存率为44.26%,15年生存率为38.88%,中位生存期为88.56个月(7.38年),最长生存期328.94个月(27.41年)。采用Log-rank检验进行单因素分析显示不同性别、不同年龄、不同职业、不同文化程度、不同医保情况、不同临床分期、不同首次治疗方法、不同放疗进展情况鼻咽癌病例的生存率差异均有统计学意义(P<0.05)。用Cox比例风险回归模型进行多因素分析显示不同年龄、不同性别、不同职业、不同临床分期、不同首次治疗方法鼻咽癌病例的生存率差异均有统计学意义(P<0.05)。鼻咽癌预后主要影响因素为年龄、性别、职业、临床分期、首次治疗方法。结论湖南省某三甲医院1992-2005年鼻咽癌住院病例1、3、5年生存率相对于该院1987-1991年鼻咽癌住院病例1、3、5年生存率均有不同程度的提高;且该院1992-2005年鼻咽癌住院病例生存率同国内外相关文献报道相比,已达到或超过国内同级医院水平。

Objective To analyze the survival situation of inpatients with nasopharyngeal carcinoma（NPC） hospitalized in a 3A-grade hospital in Hunan Province from 1992 to 2005,and to provide scientific reference for formulating the optimum therapy,prevention and control measures for nasopharyngeal carcinoma. Methods The survival data of inpatients with NPC hospitalized in the hospital during the period of 1992-2005 were analyzed by SPSS 15.0 software and Excel 2003. Results Totally,4,600 inpatients with NPC were followed up,among which 1,740 survived,2,819 died of NPC,12 died from other causes,24 cases failed to be followed-up midway,and 5 cases completely failed to be followed-up.The follow-up response rate was 99.89%.The data deletion and loss rate was 38.65%.The one-year-,three-year-,five-year-,ten-year-,and fifteen-year-survival rates were 93.47%,76.50%,62.69%,44.26% and 38.88%,respectively.The median survival time was 88.56 months（7.38 years）,and the longest survival period was 328.94 months（27.41 years）.Univariate analysis by Log-rank test showed that the survival rate differed significantly among NPC patients with different genders,ages,occupations,educations,medical insurance,clinical stages,initial therapies and radiotherapy progress（P0.05）.Multivariate analysis by Cox proportional hazard regression model indicated that the main factors influencing the prognosis of NPC were age,gender,occupation,clinical stages and initial therapies. Conclusions The one-year-,three-year-and five-year-survival rates of NPC patients hospitalized in the 3A-grade hospital of Hunan Province during 1992 and 2005 are significantly higher than those of NPC cases hospitalized in the same hospital during 1987 and 1991.Literature review suggests that their survival rates during 1992 and 2005 have reached or surpassed those of NPC patients hospitalized in other domestic hospitals at the same level.