胃癌术后预后影响因素的Cox分析

Cox Regression Analysis on Affecting Factors of Postoperative Gastric Carcinoma

目的:观察胃癌术后不同因素对患者生存率的影响,为综合评价患者的预后及中药的临床作用提供依据。方法:回顾性分析194例胃癌术后患者的临床随访资料,采用SPSS 16.0软件对已建立的病例数据库数据进行统计分析,应用Kaplan-Meier方法计算1、3,5、10年生存率,并对相关因素进行生存率的单因素分析,比较采用Log-rank方法检验,以α=0.05为检验水准,对单因素分析有统计学意义的影响因素进行Cox回归模型多因素分析。结果:单因素分析结果显示,性别差异对术后胃癌患者的预后无显著影响(P>0.05),而手术方式,TNM分期,肝转移与否,淋巴结转移及中药对其预后有影响(P<0.05)。经Cox回归多因素分析发现:手术方式,中药参与治疗为影响患者术后生存的独立预后因素。结论:手术和中药是影响患者术后生存率的重要因素,中药可以延长胃癌术后患者的生存期,且服用中药的时间长短与生存期长短有关联性。

Objective：To observe the effects on patients＇ survival rates from different factors after gastric cancer surgery, providing supports in the clinical settings for traditional Chinese medicines, as well as the comprehensive evaluation of the patients＇recovery. Method ：The retrospective analysis of 194 gastric cancer patients＇medical records after surgery was made. SPSS 16.0 software was used in analyzing the established case database. Survival rates for one year, three years, five years and ten years were calculated by applying Kaplan - Meier method, and single factor analysis of survival rates was also conducted for related factors. By using Log - rank comparison, a= 0.05 was set up for significant level, regression model for multiple factor analysis was adopted for further analysis of single factor analysis. Results：Results of single factor analysis showed that gender difference was not significant in affecting stomach cancer patients after recovery （ P 〉0. 05 ）. However, the operation approaches,TNM stages,liver metastases or lymphatic metastasis were observed and traditional Chinese medicine was found to be significant（P 〈 0.05 ）. Cox regression model for multiple factor analysis suggested that the surgery way and traditional Chinese medicine participation were two independent factors that impacted survival rates of stomach cancer patients after surgery. Conclusion ： Surgery way and traditional Chinese medicine are two key factors affecting stomach cancer patients＇ survival rates. Traditional Chinese medicine can expand stomach patients＇ life span after surgery. More importantly, the length of time taking traditional Chinese medicine is correlated to survival time after surgery.