基于SEER数据库的直肠和直肠乙状结肠交界处腺癌术后患者预后因素分析

Analysis of prognostic factors in postoperative patients with adenocarcinoma of rectum and rectosigmoid junction based on SEER database

目的探讨影响直肠和直肠乙状结肠交界处腺癌术后患者预后的危险因素。方法采用SEER*Stat软件从SEER数据库提取2010—2015年直肠和直肠乙状结肠交界处腺癌术后患者的数据,使用R软件4.0.3版本进行统计学分析,利用"survival"包中的"coxph"函数对变量进行影响直肠和直肠乙状结肠交界处腺癌术后患者预后的单因素回归分析,并对差异具有统计学意义的变量采用Cox回归模型进行多因素分析。结果本研究共纳入23 176例术后直肠和直肠乙状结肠交界处腺癌患者。单因素分析结果显示,年龄、性别、种族、TNM分期、化疗、放疗、骨转移、肺转移、肝转移均为影响直肠和直肠乙状结肠交界处腺癌术后患者预后的重要临床因素,差异具有统计学意义(P<0.05)。Cox多因素回归分析显示,年龄、性别、种族、TNM分期、化疗、骨转移、肺转移、肝转移是影响患者预后的独立因素,差异具有统计学意义(P<0.05)。结论影响直肠和直肠乙状结肠交界处腺癌术后患者的危险因素包括性别、年龄、种族、TNM分期、化疗、骨转移、肺转移、肝转移,但当前对于该部位腺癌的研究较少,因此未来仍需对术后直肠和直肠乙状结肠交界处腺癌进一步深入研究。

Objective To investigate the risk factors for the prognosis in postoperative patients with adenocarcinoma of rectum and rectosigmoid junction.Methods The data of postoperative patients with adenocarcinoma of rectum and rectosigmoid junction from 2010 to 2015 were extracted from SEER database by SEER*Stat software.R software version 4.0.3 was used for statistical analysis.The"coxph"function in the"survival"package was used for univariate regression analysis of variables affecting the prognosis of postoperative patients with adenocarcinoma of rectum and rectosigmoid junction,and Cox regression model was used for multivariate analysis of variables with statistical significance.Results A total of 23176 postoperative patients with adenocarcinoma of rectum and rectosigmoid junction were included in this study.The univariate analysis result showed that age,gender,race,TNM stage,chemotherapy,radiotherapy,bone metastasis,lung metastasis and liver metastasis were important clinical factors affecting the prognosis of postoperative patients with adenocarcinoma of rectum and rectosigmoid junction,and the differences were statistically significant(P<0.05).The Cox multivariate regression analysis showed that age,gender,race,TNM stage,chemotherapy,bone metastasis,lung metastasis and liver metastasis were independent factors affecting the prognosis of patients,and the differences were statistically significant(P<0.05).Conclusion The risk factors affecting the prognosis of postoperative patients with adenocarcinoma of rectum and rectosigmoid junction include gender,age,race,TNM stage,chemotherapy,bone metastasis,lung metastasis and liver metastasis.However,there are few studies on adenocarcinoma of this site,so further studies for adenocarcinoma of rectum and rectosigmoid junction are needed in the future.