年龄范围内的骨髓瘤存活率的性别差异:国家癌症数据库分析 (2004-2016)
Lindsay A Williams1, Sofia Barragan2, Zhanni Lu2
1Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA; Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA.
Cancer epidemiology
|April 4, 2024
概括
患有骨肉瘤的男性的生存率比女性更差,即使考虑到治疗和疾病因素. 这表明生物或其他未知的因素可能会影响男性骨髓瘤患者的长期结果.
科学领域:
- 在瘤学瘤学.
- 癌症研究 癌症研究
- 流行病学 流行病学
背景情况:
- 骨髓瘤发病率呈现双模模式,在青春期和晚年成年期达到顶峰.
- 男性不成比例地被诊断患有骨髓瘤,与女性相比,男性的生存率较低.
- 现有的生存分析往往忽视了接受治疗对基于性别的生存差异的影响.
研究的目的:
- 为了研究骨髓瘤存活率中的性别差异.
- 根据接受的治疗和其他疾病特征对生存分析进行分层.
- 为了确定在骨髓瘤结局中观察到的性别差异的潜在驱动因素.
主要方法:
- 利用国家癌症数据库 (2004-2016,n=9017) 进行生存估计.
- 使用卡普兰-梅尔生存曲线和Log-Rank p值来评估长期生存差异.
- 应用了考克斯回归模型来估计性别的危险比率 (HR) 和95%置信区间 (CI) 作为死亡率的预测指标.
主要成果:
- 男人占所有年龄组骨髓瘤病例的52-58%.
- 卡普兰-梅尔分析显示,0-19,20-39岁和≥60岁的男性的整体存活率较差 (Log-Rank p<0.05).
- 调整后的考克斯模型表明,0-19岁的男性死亡风险更高 (HR总值:1.24),仅在20-39岁年龄组接受手术的人 (HR:4.67),以及老年人特定瘤位置.
结论:
- 患有骨髓瘤的年轻男性的生存率更差,即使控制了主要疾病特征和治疗,也仍然存在.
- 这些发现强调了需要探索治疗之外的机制,例如生物因素,推动骨髓瘤存活率的性别差异.
- 需要进行进一步的研究,以阐明被诊断为骨髓瘤的男性长期生存率较低的根本原因.
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