摘要
目的 分析目前版本的华西肠癌数据库(Database from Colorectal Cancer,DACCA)中结直肠癌患者的文化程度与预后的关系.方法 本次数据分析选取的DACCA版本为2022年9月12日更新版,其中分析的数据项目包括年龄、性别、文化程度、肿瘤部位、肿瘤性质、病理TNM分期、生存状态和生存时间,按文化程度分为文盲、初等教育、中等教育及高等教育,比较不同文化程度结直肠癌患者行根治性切除术后总体生存和疾病特异性生存情况,再对不同病理TNM分期下不同文化程度结直肠癌患者术后预后情况是否有差异进行分层分析.结果 本研究共筛选出符合研究条件的数据3 692条,其中文盲202条、初等教育1 054条、中等教育1 809条、高等教育627条;病理TNM分期0期13条、Ⅰ期406条、Ⅱ期1193条、Ⅲ期1139条、Ⅳ期941条.4种文化程度患者的病理TNM分期和肿瘤性质比较差异无统计学意义(P＞0.05),而其性别、年龄及肿瘤部位比较差异有统计学意义(P＜0.001).Kaplan-Meier法绘制了总体生存和疾病特异性生存曲线,均未发现它们在不同文化程度结直肠癌患者间比较差异有统计学意义(x2=1.982,P=0.576;x2=2.618,P=0.454),分层分析也未发现它们在病理TNM分期Ⅰ～Ⅳ期各期患者中不同文化程度结直肠癌患者间比较差异有统计学意义(Ⅰ～Ⅳ期患者的总体生存曲线比较分别为:x2=1.361、P=0.715,x2=3.507、P=0.320,x2=3.144、P=0.370,x2=4.993、P=0.172;Ⅰ～Ⅳ期患者的疾病特异性生存曲线比较分别为:x2=0.723、P=0.868,x2=3.295、P=0.348,x2=4.767、P=0.190,x2=6.177、P=0.103).结论 本研究基于真实世界大数据分析结果提示,总体生存情况和疾病特异性生存情况在不同文化程度(文盲、初等教育、中等教育及高等教育)结直肠癌患者间比较差异未见有统计学意义,而且根据病理TNM分期进行分层分析的结果与此一致,今后可排除本研究存在的局限性后结合治疗细节或扩大样本数据等进一步分析,以寻求更真实的结果.
Abstract
Objective To analyze the relation between the literacy and prognosis in the patients with colorectal cancer(CRC)in the current version of the Database from Colorectal Cancer of West China(DACCA).Methods The version of DACCA selected for this data analysis was updated on September 12,2022.The data items analyzed included age,gender,literacy,tumour site,nature of tumour,pathological TNM(pTNM)stage,survival status,and survival time.The overall survival and disease-specific survival of the CRC patients with different literacy(illiteracy,primary,secondary,and tertiary educations)after radical resection were compared,and then which were analyzed in the patients with different pTNM stages.Results A total of 3 692 data eligible for the study were screened,of which 202 were illiteracy,1 054 were primary education,1 809 were secondary education,and 627 were tertiary education;And there were 13 of stage 0,406 of stage Ⅰ,1 193 of stage Ⅱ,1 139 of stage Ⅲ,and 941 of stage Ⅳ.The differences in the comparison of the pTNM stage and the nature of the tumour among the patients with the four levels of literacy were not statistically significant(P＞0.05),while the differences in the comparison of the gender,age,and tumour site were statistically significant(P＜0.001).The overall survival and disease-specific survival curves of the CRC patients with different literacy had no statistical differences(x2=1.982,P=0.576;x2=2.618,P=0.454),and the stratified overall survival curves had no statistical differences among the patients with pTNM stages Ⅰ to Ⅳ(stage Ⅰ:x2=1.361,P=0.715;stage Ⅱ:x2=3.507,P=0.320;stage Ⅲ:x2=3.144,P=0.370;stage Ⅳ:x2=4.993,P=0.172),and the stratified disease-specific survival curves had no statistical differences(stage Ⅰ:x2=0.723,P=0.868;stage Ⅱ:x2=3.295,P=0.348;stage Ⅲ:x2=4.767,P=0.190;stage Ⅳ:x2=6.177,P=0.103).Conclusions The results of this study based on real-world big data analysis suggests that the differences of overall survival and disease-specific survival of CRC patients with different literacy levels(illiterate,primary,secondary,and tertiary education)are not statistically significant,and the results of stratified analysis based on pTNM staging are consistent with this.In the future,limitations of this study can be excluded and further analysis can be conducted by combining treatment details or expanding sample data to seek more realistic results.
基金项目
国家自然科学基金青年基金(72104157)
四川大学大学生创新创业训练计划(C2023125081)
维普
万方数据