以医院为基础的233例结直肠癌登记患者的生存率分析

Survival of Patients with Colorectal Cancer in A Hospitalbased Cancer Registry:A Report of 233 Cases

[目的]对南通市肿瘤医院2002~2014年以医院为基础的肿瘤登记结直肠癌病例做生存率分析,为制定结直肠癌患者防治策略提供可靠依据。[方法]对癌症登记数据库中启东、海门籍的结直肠癌住院患者开展主动与被动相结合的方法进行生存结局的随访。用寿命表法计算观察生存率,并用Wilcoxon统计分析比较生存率的差别。[结果]2002~2014年间南通市肿瘤医院共收治启东、海门籍结直肠癌患者237例,随访截止于2016年3月31日,共获得癌症生存结局信息233例,失访4例,随访率为98.31%。233例纳入病例中,男性136例,女性97例;结肠癌93例,直肠癌140例;首次入院平均年龄为（66.82±7.94）岁。在各年龄组中50~74岁共计175例,占75.11%。结直肠癌患者的1、3、5、10年总观察生存率分别为75.11%、48.60%、36.36%和28.14%,其中直肠癌住院患者的观察生存率优于结肠癌患者,两组比较总体生存率差异有统计学意义（Gehan=7.172,P=0.007）。在结直肠癌患者中男性1、3、5、10年观察生存率分别为72.79%、46.69%、34.04%和22.59%,而女性分别为78.35%、51.29%、40.18%和37.32%,两组比较差异无统计学意义（Gehan=0.189,P=0.664）。海门籍结直肠癌患者生存率与启东籍患者比较,差异无统计学意义（Gehan=1.083,P=0.298）。0~44岁、45~54岁、55~64岁、65~74岁及75岁以上各年龄组的5年生存率分别为7.33%、31.53%、43.17%、41.66%和24.31%（Gehan=3.194,P=0.526）。[结论 ]以医院为基础的肿瘤登记可作为肿瘤防治工作的基础,可为评估结直肠癌患者接受正规治疗后的综合效果和结局提供参考依据。

[Purpose] To analyze survival of patients with colorectal cancer patients from hospitalbased cancer registration for the years 2002-2014 in Nantong Tumor Hospital. [Methods] Active follow-up and passive follow-up methods were used to obtain the information on survival of patients from Qidong city and Haimen city. Survival probability was estimated by using the life-table method,and SPSS software was used and comparison was made by Wilcoxon Statistic. [Results]The outcomes of 233 patients were identified in the follow-up for 237 cases from Qidong and Haimen until the 31 st March,2016,with a follow-up rate of 98.31%. Among 233 patients,there were 136 males and 97 females;93 cases of colon cancer and 140 cases of rectal cancer. The average age of the first admission was（66.82±7.94） years. The most commonly affected ages were 50~74 years,accounting for 75.11%. The 1-,3-,5-,and 10-year observed survival（OS） rate of colorectal cancer were 75.11%,48.60%,36.36% and 28.14%,respectively. The overall survival of rectal cancer was better than that of colon cancer（Gehan=7.172,P=0.007）. The 1-,3-,5-,and 10-year OS rates were 72.79%,46.69%,34.04% and 22.59% in males,and 78.35%,51.29%,40.18% and37.32% in females（Gehan=0.189,P=0.664）;and there was no significant difference in OS between patients from Qidong and from Haimen（Gehan =1.083,P =0.298）. The survival rates of colorectal cancer at age groups of 0~44,45~54,55~64,65~74 and 〉75 years were 7.33%,31.53%,43.17%,41.66% and 24.31%,respectively（Gehan=3.194,P=0.526）. [Conclusion] Hospital-based cancer registration is the basis of prevention and treatment,and the data provides for the estimate of the comprehensive effect and outcomes,it will be useful for cancer prevention and control in the future.