从SEER数据库分析早期胃癌中第二恶性瘤的风险因素
Lei Song1,2, Fei Zhao1, Lijing Zhang1
1Key Laboratory of Environmental Ecology and Population Health in Northwest Minority Areas, State Ethnic Affairs Commission, Northwest Minzu University, Lanzhou, China.
Scientific reports
|July 31, 2024
概括
具有特定组织学类型的胃癌患者面临更高的二次原发性恶性瘤 (SPMs) 风险. 手术方法和化疗等治疗因素也会影响癌症幸存者的SPM发展.
科学领域:
- 在瘤学瘤学.
- 癌症流行病学 癌症流行病学
背景情况:
- 胃癌 (GC) 幸存者患二次原发性恶性瘤 (SPMs) 的风险增加.
- 确定SPM的预测性风险因素对于改善患者的治疗结果和指导监测策略至关重要.
研究的目的:
- 研究临床特征,并确定在一大群胃癌患者中发现SPM发展的预测性风险因素.
- 开发和验证一个预测模型 (nomogram) 在GC幸存者的累积SPM发病率.
主要方法:
- 在2010年至2015年期间接受治疗的167747名胃癌患者的回顾性分析.
- 卡普兰 - 梅尔分析用于SPM的累积发病率.
- 竞争性风险分析使用分层的Cox比例危险回归和多变量分析来确定SPM的独立预测因素.
- 开发和内部验证用于预测SPM风险的名图.
主要成果:
- 在3289名分析的GC患者中,有155人被诊断为SPM.
- 除腺癌 (AC) 和结环细胞癌 (SRCC) 之外的其他组织学类型是SPM的独立风险因素 (HR 2.262).
- 手术方法 (活检/局部切除,亚总/总切除),化疗和组织学类型在竞争风险模型中被确定为独立的风险因素.
- 亚组分析表明,在接受化疗的老年患者中,SPM风险增加.
- 开发的诺米图表显示出良好的预测准确性 (C指数=0.73在72个月).
结论:
- 胃癌的特定组织学类型,局部切除后的淋巴结状况和化疗与二次原发性恶性瘤的风险增加有关.
- 开发的诺米图可以帮助预测SPM风险,并可能指导胃癌幸存者的个性化监测.
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