基于SEER数据库直肠印戒细胞癌的临床病理特点及预后因素分析

Analysis on clinicopathological characteristics and prognostic factors of rectal signet ring cell carcinoma based on SEER database

目的探讨直肠印戒细胞癌(SRCC)的临床病理特点及预后相关影响因素。方法从SEER数据库中提取2004-2015年诊断为直肠SRCC的患者资料,对其进行回顾性分析。采用Kaplan-Meier法分析癌症特异性生存期(CSS)和总生存期(OS),单因素和多因素Cox比例风险模型进行预后相关因素的分析。结果总共纳入492例患者,中位年龄57(14~93)岁。多数患者在初诊时为中晚期,Ⅲ、Ⅳ期所占比例分别为43.1%、35.6%,76.6%患者组织学分级为高级别。1、3、5年癌症特异性生存率和总生存率分别为63.7%、31.5%、26.2%,60.7%、28.4%、22.9%。组织学分级为高级别、TNM分期晚、肿瘤>5 cm是CSS及OS较差的独立因素(P<0.05),接受手术治疗和化疗是提高CSS和OS的独立因素(P<0.05)。结论直肠SRCC患者预后差,组织学分级、TNM分期、肿瘤大小、手术、化疗是CSS和OS的影响因素,放疗对直肠SRCC患者生存的影响有待进一步研究。

Objective To investigate the clinicopathological characteristics,prognosis related influencing factors of rectal signet ring carcinoma(SRCC).Methods The data of the patients diagnosed rectal SRCC during 2004-2015 were extracted from the SEER database and retrospectively analyzed.The cancer-specific survival(CSS)and overall survival(OS)were analyzed by using the Kaplan-Meier method,and the prognostic-related factors were analyzed by using the univariate and multivariate Cox proportional hazards models.Results In total,492 patients were included,with a median age of 57 years old(14-93 years old).The majority of the patients were at the middle and late stage in the initial diagnosis,and the stageⅢandⅣaccounted for 43.1%and 35.6%,respectively,and 76.6%of patients had a high-grade histological grade.The 1,3,5 cancer-specific survival rate and overall survival rate were 63.7%,31.5%,26.2%,and 60.7%,28.4%and 22.9%,respectively.The high-grade in the histological garde,late TNM stage,and tumor>5 cm were the independent factors for poor CSS and OS(P<0.05).Receiving the surgical treatment and chemotherapy were the independent factors for improving CSS and OS(P<0.05).Conclusion The patients with rectal SRCC have a poor prognosis,and the histological grade,TNM stage,tumor size,surgery and chemotherapy are the independent factors affecting CSS and OS.The effect of radiotherapy on the survival of SRCC patients needs further study.