基于医院信息化构建结肠癌专病队列方法学探索

Methodological exploration of constructing colon cancer specific disease cohort based on hospital informatization

目的基于疾病和有关健康问题的国际统计分类(ICD-10)首页编码系统和其他信息化系统建立结肠癌队列,并通过生存分析验证建立队列的可信性。方法从ICD-10首页编码系统数据库、肿瘤报卡数据库和病理数据库中,以身份证号为唯一字段,提取2013年1月至2019年12月浙江大学附属金华医院ICD-10首页编码系统、病理系统、疾控中心的肿瘤报卡系统中入院治疗的结肠癌患者信息。对上述3个数据库,进行清洗、合并,最后生成结肠癌队列,进行病理分期,从而分析结肠癌的预后。结果从ICD-10首页编码系统,共筛查获取了1 148例结肠癌患者;从病理数据库中,共筛查获取入组1 060例结肠癌患者,与ICD-10首页编码系统数据库进行合并形成病理病案数据库;最后与831例从肿瘤报卡数据库中筛选入组的结肠癌患者取交集,生成包含581例结肠癌患者的队列。将建立的队列进行生存分析验证,发现该中心建立的结肠癌数据库与其他研究得出的结果相仿。结论利用医院现有的ICD-10首页编码系统、病理系统与疾控中心的随访系统相结合建立肿瘤数据库是真实可信的,推广该模式有助于在全国范围内建立结肠癌队列。

Objective International Classification of Diseases(ICD-10) homepage coding system and other information systems were used to establish a colon cancer database, and the credibility of the cohort was verified through survival analysis.Methods Patients with colon cancer admitted to the hospital between January 2013 and December 2019 were extracted by ID numbers from the ICD-10 homepage coding system,the cancer reporting system database and the pathology database,respectively. The three databases were then cleaned and merged to create the colon cancer cohort. The pathological staging of the colon cancer cohort was performed to analyze the prognosis of colon cancer. Results Totally 1 148 patients with colon cancer were screened and obtained from ICD-10 home page coding system;1 060 colon cancer patients were screened and enrolled from the pathological database,which was combined with ICD-10 home page coding system database to form a pathological record database;finally,a cohort of 581 colon cancer patients was generated by intersections with 831 colon cancer patients screened from the cancer report card database. A survival analysis of the cohort found that the center’s colon cancer database matched the results of other studies. Conclusion It is credible to establish a tumor cohort by using the existing ICD-10 homepage coding system,the pathology system of the hospital and the cancer reporting and follow-up system established by the center for disease control and prevention. And expanding this model would help build colon cancer databases nationwide.