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辽宁省三城市居民2000—2002年肝癌10年生存率分析
引用本文:那军,安晓霞,李恂,张薇薇,穆慧娟,礼彦侠,潘国伟,刘莉.辽宁省三城市居民2000—2002年肝癌10年生存率分析[J].实用肿瘤学杂志,2022,36(4):293-298.
作者姓名:那军  安晓霞  李恂  张薇薇  穆慧娟  礼彦侠  潘国伟  刘莉
作者单位:1.辽宁省疾病预防控制中心慢病所(沈阳 110005); 2.本溪市疾病预防控制中心慢病科; 3.沈阳市疾病预防控制中心慢病科; 4.鞍山市疾病预防控制中心慢病科; 5.中国医科大学公共卫生学院
基金项目:辽宁省兴辽英才计划项目(编号:XLYC1802131);辽宁省自然科学基金指导计划(编号:20180550495)
摘    要:目的 分析辽宁省城市居民肝癌患者10年生存状况及其影响因素,为评估肝癌防治水平的进展提供基础数据。方法 对辽宁省三市2000—2002年肿瘤发病数据库中随机抽取的337例肝癌患者主动随访并收集信息。采用寿命表法计算观察生存率(Observed survival rate,OSR)和中位生存期(Median survival time,T50),应用Ederer Ⅱ方法计算相对生存率(Relative survival rate,RSR),采用多因素Cox回归模型分析生存期的影响因素。结果 辽宁省城市居民肝癌 T50、10年OSR和RSR分别为7.33个月、4.15%和5.17%。女性肝癌患者T50高于男性(P<0.05),但10年OSR和RSR无统计学差异。<65岁组10年OSR和RSR分别为5.73%和6.35%,略高于65~74岁组(2.15%和3.27%)和≥75岁组(1.92%和4.02%),但差异无统计学意义(P>0.05)。<65岁组的T50(7.68个月)显著高于65~74岁组(6.89个月)和≥75岁组(6.93个月)(W=5.837,P=0.016;W=8.000,P=0.005)。<65岁年龄组的10年RSR趋势与65~74岁和≥75岁年龄组存在统计学差异(χ2=6.736,P<0.05;χ2=5.992,P<0.05),Ⅰ~Ⅱ期与Ⅲ期及Ⅳ期10年生存曲线趋势均存在统计学差异(χ2=9.391,P<0.05;χ2=25.475,P<0.05),手术组与非手术组10年RSR趋势差异有统计学意义(χ2=10.767,P<0.05),手术组的T50显著高于非手术组(W=14.746,P<0.001)。多因素Cox回归模型分析结果显示,性别和临床分期对肝癌10年生存期的影响有统计学意义。结论 早期诊断率和规范性诊疗率低可能是辽宁省城市居民肝癌10年RSR低于亚洲和欧洲发达国家水平的主要原因,因此提高肝癌早诊率、加强规范诊疗、预防肝炎和肝硬化是我省肝癌防治的重要方向。

关 键 词:肝癌  10年相对生存率  中位生存期  分期  
收稿时间:2021-08-16

Analysis of 10-year survival rate of liver cancer among residents in three cities of Liaoning province from 2000 to 2002
NA Jun,AN Xiaoxia,LI Xun,ZHANG Weiwei,MU Huijuan,LI Yanxia,PAN Guowei,LIU Li.Analysis of 10-year survival rate of liver cancer among residents in three cities of Liaoning province from 2000 to 2002[J].Journal of Practical Oncology,2022,36(4):293-298.
Authors:NA Jun  AN Xiaoxia  LI Xun  ZHANG Weiwei  MU Huijuan  LI Yanxia  PAN Guowei  LIU Li
Affiliation:1. Institute of Chronic Diseases,Liaoning Provincial Center for Disease Control and Prevention,Shenyang 110005,China; 2. Institute of Chronic Diseases,Benxi Center for Disease Control and Prevention; 3. Institute of Chronic Diseases,Shenyang Center for Disease Control and Prevention; 4. Institute of Chronic Diseases,Anshan Center for Disease Control and Prevention; 5. School of public health,China Medical University
Abstract:Objective The aim of this study was to analyze the 10-year survival status and influence factors of liver cancer patients from urban residents in Liaoning province,and to provide basic data for evaluating the progress of liver cancer prevention and treatment.Methods A total of 337 hepatocellular carcinoma patients randomly selected from the tumor incidence report database in three cities of Liaoning province from 2000 to 2002 were actively followed up and information was collected.The observed survival rate(OSR)and median survival time(T50)were calculated by the life table method.The Ederer Ⅱ method was used to calculate the relative survival rate(RSR).The multivariate Cox model was used to analyze the factors affecting survival.Results The T50,10-year OSR and RSR of urban residents with liver cancer in Liaoning province were 7.33 months,4.15% and 5.17%,respectively.There were no significant differences in T50,10-year OSR and RSR between male and female liver cancer patients.The 10-year OSR and RSR of the <65 years old group were 5.73% and 6.35%,respectively,which were slightly higher than those of the 65-74 years old group(2.15% and 3.27%)and the ≥75 years old group(1.92% and 4.02%),but there was no statistical difference.The T50(7.68 months)in the < 65 years old group was significantly higher than that in the 65-74 years old group(6.89 months)and the ≥75 years old group(6.93 months)(W=5.837,P=0.016;W=8.00,P=0.005).The 10-year RSR trend of the <65 years old was significantly different from that of the 65-74 years old and the >75 years old(χ2=6.736,P<0.05;χ2=5.992,P<0.05).The trend of the 10-year survival curve in the stage Ⅰ-Ⅱ was significantly different from that of stage Ⅲ and Ⅳ(χ2=9.391,P<0.05;χ2=25.475,P<0.05).The trend of the 10-year RSR between the surgery group and the non-surgery group was significantly different(χ2=10.767,P<0.05).The T50 of the surgery group was significantly higher than that of the non-surgery group(W=14.746,P<0.001).The results of multivariate Cox model analysis showed that gender and clinical stage had significant effects on 10-year survival time of liver cancer.Conclusion The low rate of early detection and standardized diagnosis may be the main reason.why the 10-year relative survival rate of liver cancer among urban residents in Liaoning province is lower than that of developed countries in Asia and Europe,so improve the early detection rate of liver cancer,strengthening compliance with the standardized diagnosis and treatment,preventing hepatitis and cirrhosis are an important direction for liver cancer control and prevention.
Keywords:Liver cancer  10-year relative survival rate  Median survival time  Staging  
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