基于SEER数据库的宫颈癌预后回顾性研究

A Retrospective Study on the Prognosis of Cervical Cancer Based on SEER Database

摘要: 目的：探讨不同分期宫颈癌患者的预后及年龄、人种和婚姻状况对预后的影响。方法：搜索SEER数据库2010年~2015年病理诊断明确的宫颈癌患者，共计17,291例，除去随访不完整的患者，共15,895例。统计发病年龄和3年、5年生存率。Kaplan-Meier (K-M)法绘制生存曲线，Log-rank检验和Cox回归比较年龄、人种和婚姻对生存率的影响。结果：全部患者中位年龄为50岁，平均年龄52.02 ± 14.01岁。通过生存统计可见3年生存率I期 > II期 > III期 > IV期，但在具体分期生存率IIA1 > IB2 > IIB > IIA2，IIIB > IIIA。5年生存率I期 > II期 > III期 > IV期，但IIB > IIA2、IIIB > IIIA。无论是3年生存率还是5年生存率IIB期均好于IIA2期，IIIB期均好于IIIA期。从单变量分析来看在II期中白人与其他人种之间无明显差别，其余各期白人预后均好于其他人种。小于50岁患者预后均好于大于等于50岁患者，丧偶患者预后均为最差。多因素分析中人种、年龄和婚姻均有差别。结论：随着I、II、III和IV期增加总生存率下降，IIB期 > IIA2期，P = 0.007，IIIB期 > IIIA期，P = 0.025。人种、年龄及婚姻状况是预后独立因素。

Abstract: Objective: To explore the prognosis of different stages of cervical cancer patients and the influence of age, race and marital status on the prognosis. Methods: 17,291 cervical cancer patients with definite pathological diagnosis were searched in SEER database from 2010 to 2015. 15,895 patients were excluded from incomplete follow-up. The age of onset and 3-year and 5-year survival rates were analyzed. Kaplan-Meier (K-M) method was used to draw survival curve. Log-rank test and Cox regression were used to compare the effects of age, race and marriage on survival. Conclusion: the median age of all patients was 50 years old, with an average age of 52.02 ± 14.01 years. According to the 3-year survival rate, stage I > stage II > stage III > stage IV, but in the specific stage IIA1 > stage IB2 > stage IIB > stage IIA2, stage IIB > stage IIA. The 5-year survival rate was stage I > stage II > stage III > stage IV, but IIB > IIA2, IIIB > IIIA. The 3-year or 5-year survival rate of stage IIB was better than that of stage IIA2, and stage IIIB was better than that of stage IIIA. From univariate analysis, there was no significant difference between whites and other races in phase II. univariate analysis showed that the prognosis of white people was better than that of other ethnic groups, and the prognosis of patients under 50 years old was better than that of patients over 50 years old, and the prognosis of widowed patients was the worst. There were differences in race, age and marriage in multivariate analysis. Conclusion: with the increase of stage I, II, III and IV, the overall survival rate decreased. Stage IIB > stage IIA2, P = 0.007, stage IIIB > stage IIIA, P = 0.025. Race, age and marital status were independent prognostic factors.