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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摘要
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.
AIM To retrospectively analyze the epidemiological characteristics and survival of Chinese Hui and Han patients with three types of upper gastrointestinal cancer in Ningxia.METHODS A total of 5616 hospitalized Hui and Han patients with upper gastrointestinal cancer(esophageal cancer, cardia cancer or gastric cancer) treated at the General Hospital of Ningxia Medical University from January 1, 2003 to December 31, 2012 were included in this study. The date of diagnosis was set as a starting point for observation and the date of death due to upper gastrointestinal cancer was set as the end of the observation, with a calculated survival time as of January 26, 2016. All patients who underwent surgery for upper gastrointestinal cancer(3634 cases) were followed by telephone, and a final successful follow-up was achieved in 1454 patients. A database was created to analyze the clinical characteristics including patients' age, sex, ethnicity, hospitalization time, out come variables, and survival time by descriptive statistical method. The 1-, 3-, and 5-year survival rates were calculated using the lifetable method. The median survival time was calculated by Kaplan-Meier method. Survival rates were compared using the Log-rank test.RESULTS Of the 5616 hospitalized patients included, 4695(83.5%) were Han Chinese, and 921(16.5%) were Hui Chinese. The ratio of Han to Hui patients was 5.10:1. There were 4325 male patients(77.0%) and 1291 female patients(23.0%). The ratio of male to female patients was 3.35:1. There were 1563(27.8%) cases of esophageal cancer, 1478(26.3%) cases of cardia cancer, and 2575(45.9%) cases of gastric cancer. Esophageal cancer and cardiac cancer were mainly seen in patients aged ≥ 60 years(67.7% and 63.9%, respectively). Gastric cancer was mainly seed in patients aged 40-60 years(45.9%) and ≥ 60 years(45.1%). Of 3634 patients who underwent surgery for upper gastrointestinal cancer, 794 had esophageal cancer, in which the median survival time of Hui and Han patients was 29 mo vs 38 mo, and the 1-, 3-, and 5-year survival rates of Hui and Han patients were 72.3% vs 74.7%, 46.8% vs 50.9%, and 23.4% vs 30.9%, respectively; 734 had cardia cancer, in which the mediansurvival time of Hui and Han patients was 62 mo vs 33 mo, and the 1-, 3-, and 5-year survival rates of Hui and Han patients were 73.9% vs 76.3%, 58.7% vs 48.0%, and 54.3% vs 39.9%, respectively; 2106 had gastric cancer, in which the median survival time of Hui and Han patients was 98 mo vs 81 mo, and the 1-, 3-, and 5-year survival rates of Hui and Han patients were 77.3% vs 77.0%, 50.7% vs 48.1%, and 24.7% vs 22.7%, respectively. There was no signifi cant difference in the 1, 3, 5-year survival rates between Hui and Han patients with esophageal cancer, cardia cancer or gastric cancer(P > 0.05).CONCLUSION The distribution of sex and age in patients with the three types of upper gastrointestinal cancer in Ningxia is similar to that in other regions of China. The number of patients with gastric cancer and cardia cancer had an increasing trend during the past years. The 5-year survival rate of patients with gastric cancer in the northern regions including Ningxia is lower than that of the southern population.
AIM To retrospectively analyze the epidemiological characteristics and survival of Chinese Hui and Han patients with three types of upper gastrointestinal cancer in Ningxia.METHODS A total of 5616 hospitalized Hui and Han patients with upper gastrointestinal cancer(esophageal cancer, cardia cancer or gastric cancer) treated at the General Hospital of Ningxia Medical University from January 1, 2003 to December 31, 2012 were included in this study. The date of diagnosis was set as a starting point for observation and the date of death due to upper gastrointestinal cancer was set as the end of the observation, with a calculated survival time as of January 26, 2016. All patients who underwent surgery for upper gastrointestinal cancer(3634 cases) were followed by telephone, and a final successful follow-up was achieved in 1454 patients. A database was created to analyze the clinical characteristics including patients' age, sex, ethnicity, hospitalization time, out come variables, and survival time by descriptive statistical method. The 1-, 3-, and 5-year survival rates were calculated using the lifetable method. The median survival time was calculated by Kaplan-Meier method. Survival rates were compared using the Log-rank test.RESULTS Of the 5616 hospitalized patients included, 4695(83.5%) were Han Chinese, and 921(16.5%) were Hui Chinese. The ratio of Han to Hui patients was 5.10:1. There were 4325 male patients(77.0%) and 1291 female patients(23.0%). The ratio of male to female patients was 3.35:1. There were 1563(27.8%) cases of esophageal cancer, 1478(26.3%) cases of cardia cancer, and 2575(45.9%) cases of gastric cancer. Esophageal cancer and cardiac cancer were mainly seen in patients aged ≥ 60 years(67.7% and 63.9%, respectively). Gastric cancer was mainly seed in patients aged 40-60 years(45.9%) and ≥ 60 years(45.1%). Of 3634 patients who underwent surgery for upper gastrointestinal cancer, 794 had esophageal cancer, in which the median survival time of Hui and Han patients was 29 mo vs 38 mo, and the 1-, 3-, and 5-year survival rates of Hui and Han patients were 72.3% vs 74.7%, 46.8% vs 50.9%, and 23.4% vs 30.9%, respectively; 734 had cardia cancer, in which the mediansurvival time of Hui and Han patients was 62 mo vs 33 mo, and the 1-, 3-, and 5-year survival rates of Hui and Han patients were 73.9% vs 76.3%, 58.7% vs 48.0%, and 54.3% vs 39.9%, respectively; 2106 had gastric cancer, in which the median survival time of Hui and Han patients was 98 mo vs 81 mo, and the 1-, 3-, and 5-year survival rates of Hui and Han patients were 77.3% vs 77.0%, 50.7% vs 48.1%, and 24.7% vs 22.7%, respectively. There was no signifi cant difference in the 1, 3, 5-year survival rates between Hui and Han patients with esophageal cancer, cardia cancer or gastric cancer(P > 0.05).CONCLUSION The distribution of sex and age in patients with the three types of upper gastrointestinal cancer in Ningxia is similar to that in other regions of China. The number of patients with gastric cancer and cardia cancer had an increasing trend during the past years. The 5-year survival rate of patients with gastric cancer in the northern regions including Ningxia is lower than that of the southern population.
引文
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6陈万青,郑荣寿,张思维.中国恶性肿瘤的动态变化.科技导报2014;32:65-71
7杨文笔.西海固回族穆斯林朝觐实践的调查与研究.北方民族大学学报2014;1:115-122
8陈万青,郑荣寿,张思维,曾红梅,左婷婷,贾漫漫,夏昌发,邹小农,赫捷.2012年中国恶性肿瘤发病和死亡分析.中国肿瘤2016;25:1-8
9董颖,杨文君.消化道恶性肿瘤流行病学特征与发病现状分析.医学综述2014;20:429-431
10邹文斌,李兆申.中国胃癌发病率及死亡率研究进展.中国实用内科杂志2014;34:408-415
11姬发祥,赵久达,沈国双,曹成珠,贺菊香,马新福,王丽娟,李进章,耿排力.藏、回、汉族胃癌患者发病特征分析1165例.世界华人消化杂志2009;17:1993-1995
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14陶可胜,黄蕾.食管癌的流行病学和控制策略.中国社区医师2012;(9):5
15张国强,蒋海华,杜峥,刘倩倩,敬文,李述刚,李凡卡.2008-2012年新疆生产建设兵团居民恶性肿瘤死亡分析.现代预防医学2015;42:1247-1250
16杨霞,王学伟,李吴萍.宁夏2002年-2014年恶性肿瘤住院患者的病种分布及变化趋势分析.中国病案2016;17:62-66
17刘巍,郝希山,陈勇,李海欣,王士杰,王培忠,范倩,晋颖,关丽云,宋丽楠,平育敏,孟宪利,王瑞,刘俊锋,王小玲.1526例胸段食管癌及贲门癌淋巴结转移状况分析.中国肿瘤临床2008;35:601-605
18赵丽珍,张军,高君,范力宏.西安地区12年间胃镜检出上消化道癌症分析.西安交通大学学报(医学版)2005;26:498-501
19张蓉,张军,高麦仓,沈强,杨力,周永宁,王学红.近10年来西北地区四所医院上消化道肿瘤住院患者人口学特征分析.中华消化内镜杂志2012;29:220-222
20赵琳,王侠,杨妍,于波.1998-2007年沈阳城区居民恶性肿瘤死亡趋势分析.中国卫生统计2008;25:527-529
21阿丽亚·阿不都卡德尔,古丽娜尔,刘超,穆振诺,玛依努尔·艾力.4928例维吾尔族恶性肿瘤住院患者的疾病构成分析.现代肿瘤医学2015;23:1456-1460
22夏依木拉提·夏依马尔旦,夏力哈尔·阿勒塔依,阿依恒·曲库尔汗.新疆阿勒泰地区2055例哈萨克族、汉族恶性肿瘤构成特点分析.新疆医科大学学报2015;38:158-165
23袁建青,李兰英,赵明臻.青海地区近十年胃癌构成分析.世界华人消化杂志2007;15:1763-1765
24李国栋.1510例食管癌患者术后生存率及预后影响因素分析.太原:山西医科大学,2016
25马雅婷.河南省林州市人群食管癌、胃癌现时生存率分析.郑州:郑州大学,2009
26罗胜兰.浙江省常见恶性肿瘤生存分析.宁波:宁波大学,2014
27再依奴尔·阿不都外力,赵婷,刘志云,米热古丽·哈米提,阿布都沙拉木·依米提.2010-2014年新疆医科大学附属肿瘤医院住院病例主要恶性肿瘤生存分析.中华肿瘤防治杂志2016;23:699-703
28韩雪,赵佳,黄辰曦,谢梦,丁一波,马立业,张宏伟,曹广文.2002-2012年上海市杨浦区原发性胃癌发病及生存情况分析.中华临床医师杂志(电子版)2013;7:8169-8175
29马玉花.164例胃癌术后患者预后因素分析.乌鲁木齐:新疆医科大学,2012
2金海英,全贞玉,韩春姬.12年恶性肿瘤住院患者的疾病构成特征及变化趋势分析.中国卫生统计2013;30:393-394
3屈若祎,周宝森.2004-2010年中国肺癌死亡分布及趋势分析.中国卫生统计2014;31:932-935
4柴玉英,张向阳,李勇.我国人口主要疾病死因构成变化的影响因素.中国全科医学2010;13:1025-1027
5国家卫生和计划生育委员会.2010中国卫生统计年鉴.2014-07-30.Available from:URL:http://www.moh.gov.cn/htmlfiles/zwgkzt/ptjnj/year2010/index2010.html
6陈万青,郑荣寿,张思维.中国恶性肿瘤的动态变化.科技导报2014;32:65-71
7杨文笔.西海固回族穆斯林朝觐实践的调查与研究.北方民族大学学报2014;1:115-122
8陈万青,郑荣寿,张思维,曾红梅,左婷婷,贾漫漫,夏昌发,邹小农,赫捷.2012年中国恶性肿瘤发病和死亡分析.中国肿瘤2016;25:1-8
9董颖,杨文君.消化道恶性肿瘤流行病学特征与发病现状分析.医学综述2014;20:429-431
10邹文斌,李兆申.中国胃癌发病率及死亡率研究进展.中国实用内科杂志2014;34:408-415
11姬发祥,赵久达,沈国双,曹成珠,贺菊香,马新福,王丽娟,李进章,耿排力.藏、回、汉族胃癌患者发病特征分析1165例.世界华人消化杂志2009;17:1993-1995
12葛云叶,杨晓辉,蔡慧珍,葛箭.回、汉族饮食习惯与胃癌关系的对比研究.中国老年保健医学2011;9:13-15
13刘贺荣,宋辉,赵建华,芦晓红,刘秀英.宁夏居民主要恶性肿瘤潜在寿命损失分析.宁夏医学杂志2003;25:596-598
14陶可胜,黄蕾.食管癌的流行病学和控制策略.中国社区医师2012;(9):5
15张国强,蒋海华,杜峥,刘倩倩,敬文,李述刚,李凡卡.2008-2012年新疆生产建设兵团居民恶性肿瘤死亡分析.现代预防医学2015;42:1247-1250
16杨霞,王学伟,李吴萍.宁夏2002年-2014年恶性肿瘤住院患者的病种分布及变化趋势分析.中国病案2016;17:62-66
17刘巍,郝希山,陈勇,李海欣,王士杰,王培忠,范倩,晋颖,关丽云,宋丽楠,平育敏,孟宪利,王瑞,刘俊锋,王小玲.1526例胸段食管癌及贲门癌淋巴结转移状况分析.中国肿瘤临床2008;35:601-605
18赵丽珍,张军,高君,范力宏.西安地区12年间胃镜检出上消化道癌症分析.西安交通大学学报(医学版)2005;26:498-501
19张蓉,张军,高麦仓,沈强,杨力,周永宁,王学红.近10年来西北地区四所医院上消化道肿瘤住院患者人口学特征分析.中华消化内镜杂志2012;29:220-222
20赵琳,王侠,杨妍,于波.1998-2007年沈阳城区居民恶性肿瘤死亡趋势分析.中国卫生统计2008;25:527-529
21阿丽亚·阿不都卡德尔,古丽娜尔,刘超,穆振诺,玛依努尔·艾力.4928例维吾尔族恶性肿瘤住院患者的疾病构成分析.现代肿瘤医学2015;23:1456-1460
22夏依木拉提·夏依马尔旦,夏力哈尔·阿勒塔依,阿依恒·曲库尔汗.新疆阿勒泰地区2055例哈萨克族、汉族恶性肿瘤构成特点分析.新疆医科大学学报2015;38:158-165
23袁建青,李兰英,赵明臻.青海地区近十年胃癌构成分析.世界华人消化杂志2007;15:1763-1765
24李国栋.1510例食管癌患者术后生存率及预后影响因素分析.太原:山西医科大学,2016
25马雅婷.河南省林州市人群食管癌、胃癌现时生存率分析.郑州:郑州大学,2009
26罗胜兰.浙江省常见恶性肿瘤生存分析.宁波:宁波大学,2014
27再依奴尔·阿不都外力,赵婷,刘志云,米热古丽·哈米提,阿布都沙拉木·依米提.2010-2014年新疆医科大学附属肿瘤医院住院病例主要恶性肿瘤生存分析.中华肿瘤防治杂志2016;23:699-703
28韩雪,赵佳,黄辰曦,谢梦,丁一波,马立业,张宏伟,曹广文.2002-2012年上海市杨浦区原发性胃癌发病及生存情况分析.中华临床医师杂志(电子版)2013;7:8169-8175
29马玉花.164例胃癌术后患者预后因素分析.乌鲁木齐:新疆医科大学,2012