上海市浦东新区2002至2010年胰腺癌发病、死亡及生存情况分析

目的 分析上海市浦东新区胰腺癌发病、死亡及生存情况.方法 利用2002年至2010年浦东新区居民胰腺癌的登记资料,分性别组和年龄组计算发病率、死亡率.用世界标准人口计算标化率,采用对数直线回归法估算发病率及死亡率的年度百分比变化（APC）,应用Kaplan-Meier法和COX多元回归模型计算患者1～5年生存率,分析不同TNM分期和是否手术的胰腺癌患者的生存情况.结果 2002年至2010年上海市浦东新区胰腺癌新发患者3089例,其中男性1707例,女性1382例,平均发病年龄分别为（69±12）岁和（73±12）岁；合计粗发病率为13.32/10万,其中男性粗发病率为14.71/10万,高于女性的11.93/10万,男女性标化发病率之比为1.57：1.胰腺癌患者死亡2963例,其中男性1627例,女性1336例,合计粗死亡率为12.78/10万,其中男性为14.02/10万,高于女性的11.53/10万,男女性标化死亡率之比为1.55：1.男性在35岁、女性在40岁以后发病率和死亡率均明显升高,男性80岁以上、女性85岁以上发病率和死亡率达到高峰.胰腺癌患者1～5年生存率分别为16.59％、7.31％、5.23％、4.33％和3.87％.手术治疗组1～5年生存率均高于非手术组,差异有统计学意义（P值均＜0.05）.TNM分期为0～Ⅱ期、Ⅲ期、Ⅳ期患者的中位生存时间分别为（250.00±33.37）、（224.00±15.82）、（86.00±4.52）d.Ⅳ期患者与0～Ⅱ期及Ⅲ期患者生存时间的差异均有统计学意义（X2值分别为72.41、104.40,P值均＜0.001）.结论 上海市浦东新区男性胰腺癌发病率和死亡率均高于女性.患者的生存时间与确诊时的TNM分期及是否手术切除肿瘤有关.

Incidence, mortality and survival rates of pancreatic cancer among residents in Pudong New Area of Shanghai from 2002 to 2010

Objective To analyze the incidence,mortality and survival rates of pancreatic cancer in Pudong New Area of Shanghai from 2002 to 2010.Methods The residents in Pudong New Area of Shanghai were recruited in this study during the period 2002 ～ 2010,the incidence,mortality were calculated according to different age groups and genders.The standardized morbidity and mortality of pancreatic cancer were calculated by world standard population.Logarithmic linear regression was used to calculate the annual percentage change （APC） of incidence and mortality.The 1 ～ 5 year survival of pancreatic cancer patients was analyzed by Kaplan-Meier method and COX regression analysis,and the survival of patients with different TNM staging,with or without operation was determined.Results Among 3089 newly occurred pancreatic cancer cases during 2002 ～ 2010,1707 and 1382 cases were males and females,respectively,with an average age of （69 ± 12） and （73 ± 12） years old,the crude incidence for both genders was 13.32/100 000,and it was 14.71/100 000 for males,which was higher than that in females （11.93/100 000）.The ratio of male and female for incidence of age standardize was 1.57：1.There were 2963 death in total,including 1627 males and 1336 females,with a crude mortality rate of 12.78/100 000.The crude mortality rate for males was 14.02/100 000,which was higher than that in females （11.53/100 000）.The ratio of male and female ASR for mortality was 1.55：1.Both incidence and mortality significantly increased for males aged over 35 and females aged over 40.The peak of morbidity and mortality appeared in male over 80 years old,and in female over 85 years old.The 1 ～ 5 year survival rates of pancreatic cancer patients were 16.59%,7.31%,5.23%,4.33% and 3.87%,respectively.The differences in 1 ～5 year survival rates between surgical and non-surgical management groups were statistically significant （P 〈 0.05）.The median survival time of TNM 0 ～ Ⅱ,Ⅲ and Ⅳ staging was （250.00 ± 33.37）,（224.00 ± 15.82）,（86.00 ± 4.52） d.There was a statistically significant difference among the survival of TNM-Ⅳ and TNM 0 ～ Ⅰ,TNM Ⅲ （P 〈 0.001）.Conclusions The incidence and mortality of pancreatic cancer in males are higher than those in females in Pudong New Area of Shanghai.The survival is associated with TNM staging at diagnosis and whether surgical operation is performed.