5616例回、汉族三种上消化道肿瘤住院患者特征及生存分析

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目的回顾性分析宁夏地区回、汉族三种上消化道肿瘤患者的流行特征,为更好地开展肿瘤防治工作提供参考依据.方法收集整理2003-01-01/2012-12-31十年间在宁夏医科大学总医院住院治疗的5616例回、汉族上消化道肿瘤(食管癌、贲门癌、胃癌)患者临床资料.以患者确诊日期作为观察起点,以因上消化道肿瘤死亡的日期作为观察终点,对上消化道肿瘤手术患者(3634例)进行电话随访,随访成功1454例患者,生存时间的计算截止到2016-01-26.建立数据库,采用描述性统计方法分析患者年龄、性别、民族、入院时间、结局变量、生存时间等指标的分布特征,用寿命表法分时期和民族求出1年、3年和5年的生存率.用KaplanM e i e r法计算中位生存时间,生存率比较用Log-rank检验.结果共有5616例患者资料纳入分析,其中汉族患者4695例(83.5%),回族921例(16.5%),汉族vs回族比例为5.10 vs 1;男性患者共计4325例(77.0%),女性患者1291例(23.0%),男性vs女性比例为3.35 vs 1;食管癌患者1563例(27.8%),贲门癌患者1478例(26.3%),胃癌患者2575例(45.9%);食管癌与贲门癌均以≥60岁组(67.7%vs 63.9%)患者为主,胃癌以40-60岁组(45.9%)及≥60岁组(45.1%)患者为主.上消化道肿瘤手术患者3634例,其中食管癌手术患者794例,回、汉族中位生存时间分别为29 mo vs 38 mo,回、汉族1、3、5年生存率分别为72.3%vs 74.7%、46.8%vs50.9%、23.4%v s 30.9%.贲门癌手术患者734例,回、汉族中位生存时间分别为62 mo vs 33 mo,回、汉族1、3、5年生存率分别为73.9%vs 76.3%、58.7%vs 48.0%、54.3%vs39.9%.胃癌手术患者2106例,回、汉族中位生存时间分别为98 mo vs 81 mo,回、汉族1、3、5年生存率分别为77.3%vs 77.0%、50.7%vs 48.1%、24.7%vs 22.7%,食管癌、贲门癌、胃癌患者回、汉族间1、3、5年生存率差异均无统计学意义(P>0.05).结论宁夏地区三种上消化道肿瘤患者在性别与年龄的分布与我国其他区域相同病种患者的分布近似;宁夏地区胃癌与贲门癌患者数量呈现逐年递增趋势;包括宁夏在内的几个北方地区的胃癌人群5年生存率低于南方地区人群. Objective To retrospectively analyze the epidemiological characteristics of three kinds of upper gastrointestinal cancer patients in Ningxia Hui Autonomous Region and Han nationality and to provide a reference for better prevention and treatment of cancer.Methods To collect and analyze the epidemiological data of Ningxia from January to December in 2003 Clinical data of 5616 patients with upper gastrointestinal cancer (esophageal cancer, cardia cancer, stomach cancer) hospitalized in General Hospital of General University of Medical Science. The date of diagnosis of patients was taken as the starting point of observation and the date of death due to upper gastrointestinal cancer was taken as the end point of observation. Surveillance of upper gastrointestinal cancer patients (3634 cases) was conducted by phone, and 1454 patients were followed-up successfully, and the survival time was calculated as 2016-01-26. The database was established and the descriptive statistics was used to analyze the age, sex, ethnicity and admission Time, outcome variables, survival time and other indicators of the distribution characteristics of the life table France and sub-national and 1, 3 and 5 years survival rates calculated by KaplanM eier median survival time, the survival rate compared with Log -rank test.Results A total of 5616 patients were included in the analysis, of which 4695 were Han patients (83.5%), 921 Hui patients (16.5%), Han / Hui ratio was 5.10 vs 1. Male patients were 4 325 cases (77.0%) were female, 1291 cases (23.0%) were female, the ratio of male to female was 3.35 vs 1; 1563 cases (27.8%) of esophageal cancer, 1478 cases (26.3%) of gastric cardia and 2575 cases of gastric cancer 45.9%). Esophageal and cardia cancer were predominant in patients ≥60 years (67.7% vs 63.9%). Gastric cancer was mainly in patients 40-60 years (45.9%) and patients ≥60 years (45.1%). 3634 cases of upper gastrointestinal cancer surgery patients, including 794 cases of esophageal cancer surgery, the median survival time of the return, Han nationality was 29 mo vs 38 mo, 1, 3, 5-year survival rates were 72.3% vs 74.7% , 46.8% vs50.9%, 23.4% vs 30.9%, respectively.The number of patients with cardiac surgery was 734. The median survival time was 62 mo vs 33 mo for both cardiomyopathy patients, and the 1-, 3- and 5-year survival rates were 73.9 % vs 76.3%, 58.7% vs 48.0%, 54.3% vs39.9% .There were 2106 patients with gastric cancer who had a median survival time of 98 months vs 81 months (P> 0.05). There was no significant difference in the 1, 3 and 5-year survival rates between esophageal cancer, gastric cardia cancer and gastric cancer patients and between Han and Han nationality (77.3% vs 77.0%, 50.7% vs 48.1%, 24.7% vs 22.7% ) Conclusion Three patients with upper gastrointestinal cancer in Ningxia region The distribution of age and sex did not differ from the distribution of the same disease in other areas in China. The number of patients with gastric cancer and cardia cancer showed a trend of increasing year by year in Ningxia. The 5-year survival rate of gastric cancer patients in several northern regions including Ningxia was lower than that in southern areas crowd.
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