摘要
目的:本研究旨在分析2002—2013年上海市肝癌患者的生存情况。方法:采用上海市疾病预防控制中心建立的人群基础肿瘤登记管理系统和死因登记系统收集的2002—2013年上海市肝癌发病、死亡和随访资料,按诊断年份、性别、城郊、年龄、临床分期等不同分类进行分层分析,计算例数、构成比、中位年龄和平均年龄等相关统计指标。应用寿命表法计算病例的1~5年观察生存率,应用Elandt-Johnson模型推算0~99岁逐岁的生存概率,再根据EdererⅡ方法计算期望生存率,最终获得病例的1~5年相对生存率。结果:本研究报告分析了2002—2013年上海市新诊断的肝癌新发病例49455例,其中男性35115例,女性14340例,男性与女性发病之比为2.45∶1。诊断时的临床分期:Ⅰ期占3.32%,Ⅳ期占13.93%,临床分期不详占69.13%。中位生存期为0.77年,5年观察生存率为13.23%,5年相对生存率为14.47%。从病例的5年观察生存率和5年相对生存率来看,市区肝癌病例的这2项生存指标均高于郊区,男性病例均高于女性,45岁以下病例高于75岁以上病例,2011—2013年的病例高于2002—2004年的病例,并且病例的生存率随诊断时临床分期的升高而降低。结论:随着上海市肝癌诊疗水平的不断提高,肝癌病例的生存率随着时间变化呈现明显上升趋势,但是与胃癌和乳腺癌等多种恶性肿瘤相比,肝癌生存率的改善效果依然不明显。此外,诊断时临床分期不详病例所占比例较高,Ⅳ期病例生存率较低。本研究为肝癌的防控和研究提供了依据。
Objective:To investigate the survival rates of patients with liver cancer in Shanghai from 2002 to 2013.Methods:Data on new cases and deaths of liver cancer patients with follow-up information from 2002 to 2013 were obtained from the Population-Based Cancer Registry and Vital Statistics System of the Shanghai Municipal Center for Disease Control and Prevention.Incidence and survival rates were stratified by year of diagnosis,gender,district,age-group and stage at diagnosis for analysis.Statistical indicators,such as case numbers,proportions,median age and mean age were calculated.The 1-to 5-year observed survival rates were calculated based on the life table method.The probabilities of surviving from 0 to 99 years old were estimated with the Elandt-Johnson model,and then cumulative expected survival rates were calculated using the EdererⅡmethod.Finally,the 1-to 5-year relative survival rates were calculated.Results:A total of 49455 new cases of liver cancer were diagnosed from 2002 to 2013 in Shanghai,including 35115 males and 14340 females.The ratio of males to females was 2.45:1.The proportions of stage I,stage IV and stage unknown were 3.32%,13.93%and 69.13%,respectively.The median survival time of patients with liver cancer diagnosed from 2002 to 2013 was 0.77 years,the 5-year observed survival rate was 13.23%,and the 5-year relative survival rate was 14.47%.According to the 5-year observed survival rate and 5-year relative survival rate of the cases,both survival indicators were higher in urban areas than in suburban areas,higher in males than in females,higher in cases under 45 years of age than in those over 75 years of age,higher in cases diagnosed from 2011 to 2013 than those diagnosed from 2002 to 2004.Additionally,the survival rate of cases decreased with increasing stage at diagnosis.Conclusion:With the continuous improvement of the diagnosis and treatment of liver cancer in Shanghai,the survival rate of patients with liver cancer has shown a significant upward trend over time.However,compared with various malignant tumors such as gastric cancer and breast cancer,the improvement effect of liver cancer survival rate is still not significant.Additionally,a high proportion of cases with unknown clinical stage at the time of diagnosis and a low survival rate of stage IV cases were observed.This study provides a basis for the prevention and research of liver cancer.
作者
张琳梦
吴春晓
汪惠
顾凯
施亮
王存
覃文新
施燕
ZHANG Linmeng;WU Chunxiao;WANG Hui;GU Kai;SHI Liang;WANG Cun;QIN Wenxin;SHI Yan(State Key Laboratory of Tumor Systems Medicine,Shanghai Cancer Institute,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200032,China;Department of Cancer Control and Prevention,Division of Noncommunicable Diseases and Injury,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China)
出处
《肿瘤》
CAS
北大核心
2023年第4期347-353,共7页
Tumor
基金
国家自然科学基金国际(地区)合作与交流项目(81920108025)
国家自然科学基金面上项目(82272826)
国家重点研发计划项目(2022YFC3600800)
上海市加强公共卫生体系建设三年行动计划(2023-2025)(GWVI-8)
关键词
肝癌
生存
流行病学
上海
Liver cancer
Survival
Epidemiology
Shanghai
作者简介
Correspondence to:覃文新,E-mail:wxqin@sjtu.edu.cn Correspondence to:施燕,E-mail:shiyan@scdc.sh.cn;张琳梦,contributed equally to this work;吴春晓,contributed equally to this work
