来自SEER数据库的左右半结肠癌临床病理特点及生存分析

Differences in clinical characteristics and survival be tween left-sided and right-sided colon cancer: Analysis from the SEER database

目的比较左、右半结肠癌患者临床指标、病理学指标和预后差异,分析结肠癌患者预后生存的影响因素。方法通过SEER数据库收集结肠癌患者信息,分析比较左、右半结肠癌患者的人口学信息、临床指标和病理学指标,采用Kaplan-Meier法计算结肠癌患者总生存率,采用Log-rank检验和多因素COX回归分析结肠癌患者生存的影响因素。结果共纳入5099例患者进行分析。结肠癌患者5年总生存率为63.1%,左半结肠癌患者5年总生存率明显高于右半结肠癌患者(66.7%vs.60.5%,P<0.05)。左、右半结肠癌在性别、年龄、疾病分期、T分期、N分期、分化程度及种族分布存在差异(均P<0.05)。COX模型分析结果发现,肿瘤发生部位、年龄、性别、分化程度、疾病分期、T分期及N分期为结肠癌的预后生存的影响因素(均P<0.05),其中,右半结肠癌死亡风险度是左半结肠癌死亡风险度的1.151倍(RR=1.151,95%CI:1.046~1.267,P=0.004)。结论左、右半结肠癌在性别、年龄、疾病分期、T分期、N分期、分化程度及种族分布存在差异,右半结肠癌患者术后5年的死亡风险更高。

Objective To compare the clinical and pathological characteristics of patients with left-sided colon cancer（LSCC） and right-sided colon cancer（RSCC）, and to determine the prognostic factors of colon cancer. Methods A total of 5,099 patients were recruited. The SEER database was built by collecting data of demographics, clinical and pathologic indices of patients with colon cancer. We compared the characteristics of patients with LSCC and RSCC. Kaplan-Meier method was used to calculate and compare the survival rate. Log-rank test and COX regression were used to analyze prognostic factors. Results The 5-year survival rate of colon cancer patients was 63.1%, and the survival rate of the patients with LSCC was significantly higher than that of the patients with RSCC（66.7% vs. 60.5%, P 〈0.05）. There were differences in sex, age, pathological stage, T staging, N staging, differentiation degree and ethnicity between patients with LSCC and RSCC. The results of multivariate COX analysis showed that tumor location, age,pathological stage, T staging, N staging and differentiation were independent factors of survival of colon cancer. The risk of death in RSCC was 1.151 times of that of LSCC（RR = 1.151, 95%CI：1.046-1.267, P = 0.004）. Conclusion There were differences in sex,age, disease stage, T staging, N staging, differentiation degree and ethnicity between left and right colon cancer. Patients with right colon cancer had a higher risk of death 5 years after surgery.