基于SEER数据库的影响早期胃癌风险因素分析

Analysis of prognostic factors in patients with early gastric cancer based on SEER database

目的探索影响早期胃癌(early gastric cancer,EGC)生存的危险因素.方法选取SEER数据库经手术治疗诊断为T1期胃癌患者,采用COX比例风险模型、卡方检验(单因素分析)、Logistic回归对患者资料进行分析.结果COX比例风险模型分析显示年龄、种族、性别、肿瘤大小、病理类型、分化程度、淋巴结转移情况均为影响EGC患者预后的独立风险因素.在≤60岁EGC患者中,肿瘤大小不是影响预后的独立危险因素.在性别分组中,在种族因素中,男性中亚裔及其他总生存期要优于白人和黑人,但在女性中没有差异.男性中肿瘤大小、病理类型是影响预后的危险因素,但在女性中不是.而女性中,肿瘤分化程度是影响预后的独立风险因素,但在男性中不是.影响淋巴结转移的独立风险因素只有肿瘤大小、病理分型和分化程度.结论年龄和性别也是影响EGC患者预后的独立因素.在不同年龄段和不同性别中影响预后的风险因素也有所差异.因此,了解不同临床特征患者的危险因素对于EGC患者精准治疗提供一定的循证学证据支持.

AIM To identify the risk factors affecting the survival of patients with early gastric cancer（EGC）.METHODS The patients who were diagnosed with T1 gastric cancerafter operation were selected from the SEER database. The COX proportional hazards model, chi square test, and logistic regression were used to analyze the patients＇ data.RESULTS COX proportional risk model analysis showed that age, race, sex, tumor size, pathological type, degree of differentiation, and lymph node metastasis were independent prognostic factors for overall survival. Tumor size was not an independent risk factor for EGC in patients younger than 60 years of age. With regard to gender, race was an independent risk factor for male patients, but there was no difference among females. Tumor size and pathological type were risk factors for prognosis in males but not in females. The independent risk factors affecting lymph node metastasis were tumor size, pathological type, and degree of differentiation.CONCLUSION Age and gender are independent factors affecting the prognosis of EGC patients. There are also differences in risk factors affecting prognosis among different age groups and different gender groups. Understanding the risk factors for patients with different clinical characteristics can provide evidence-based medicine support for accurate treatment of EGC patients.