本文關(guān)鍵詞： 鼻咽癌 住院病例 生存分析 生存率　出處：《中南大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：分析湖南省腫瘤醫(yī)院1992～2005年鼻咽癌住院病例生存情況及影響因素,為醫(yī)生制訂最佳治療方案和鼻咽癌防控措施提供科學(xué)依據(jù)。 方法：采用隨訪研究收集湖南省腫瘤醫(yī)院1992年1月1日～2005年12月31日鼻咽癌住院病例的生存資料。使用Excel和SPSS15.0軟件對(duì)資料進(jìn)行分析。一般資料進(jìn)行描述性分析。病例生存分析利用壽命表法按不同臨床分期、不同治療方式等因素,計(jì)算出不同時(shí)期的生存率。對(duì)可能影響病例生存的各類因素進(jìn)行整體比較,檢驗(yàn)方法采用Wilcoxon(Gehan)檢驗(yàn)。單因素采用Kaplan-Meier法估計(jì)生存率和采用Log-rank方法對(duì)各組生存曲線分布是否相同進(jìn)行檢驗(yàn)；采用Cox比例風(fēng)險(xiǎn)回歸模型進(jìn)行多因素分析。 結(jié)果：隨訪湖南省腫瘤醫(yī)院1992～2005年鼻咽癌住院病例4600例,隨訪截止時(shí)間為2010年12月31日,其中生存1740例,因本病死亡2819例,因其他原因死亡12例,中途失訪24例,完全失訪5例,隨訪應(yīng)答率99.89%,數(shù)據(jù)刪失率38.65%。1年生存率為93.47%,3年生存率為76.50%,5年生存率為62.69%,10年生存率為44.26%,15年生存率為38.88%,中位生存期為88.56個(gè)月(7.38年)。采用Log-rank檢驗(yàn)進(jìn)行單因素分析顯示不同性別、不同年齡、不同職業(yè)、不同文化程度、不同臨床分期、不同首次治療方法、不同放療進(jìn)展情況鼻咽癌病例的生存率差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。用Cox比例風(fēng)險(xiǎn)回歸模型進(jìn)行多因素分析顯示不同年齡、不同性別、不同職業(yè)、不同臨床分期、不同首次治療方法鼻咽癌病例的生存率差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。鼻咽癌預(yù)后主要影響因素為年齡、性別、職業(yè)、臨床分期、首次治療方法。 結(jié)論：湖南省腫瘤醫(yī)院1992-2005年鼻咽癌住院病例1、3、5年生存率相對(duì)于該院1987-1991年鼻咽癌住院病例1、3、5年生存率均有不同程度的提高；且該院1992-2005年鼻咽癌住院病例生存率同國(guó)內(nèi)外相關(guān)文獻(xiàn)報(bào)道相比,已達(dá)到或超過國(guó)內(nèi)同級(jí)醫(yī)院水平。
[Abstract]:Objective: to analyze the survival status and influencing factors of nasopharyngeal carcinoma (NPC) inpatients in Hunan Cancer Hospital from 1992 to 2005 so as to provide scientific basis for doctors to formulate the best treatment plan and prevention and control measures for NPC. Methods:. The survival data of nasopharyngeal carcinoma (NPC) patients in Hunan Cancer Hospital from January 1st 1992 to December 31st 2005 were collected by a follow-up study. The data were analyzed by Excel and SPSS15.0 software. Case survival analysis using life table method according to different clinical stages. Different treatment methods and other factors were used to calculate the survival rate in different periods. The factors that might affect the survival of the patients were compared as a whole. The test method is Wilcoxonne Gehan. Single factor Kaplan-Meier method was used to estimate survival rate and Log-rank method was used to test whether the distribution of survival curve in each group was the same or not. Cox proportional risk regression model was used for multivariate analysis. Results: 4600 cases of nasopharyngeal carcinoma were followed up in Hunan Cancer Hospital from 1992 to 2005. The deadline of follow-up was December 31st 2010, of which 1 740 cases survived. There were 2 819 cases of death due to this disease, 12 cases of death due to other causes, 24 cases of lost visit and 5 cases of complete loss of visit. The follow-up response rate was 99.89%. The 38.65.1 year survival rate was 93.47, the 3-year survival rate was 76.500.The 5-year survival rate was 62.69, and the 10-year survival rate was 44.26%. The 15-year survival rate was 38.88 and the median survival time was 88.56 months (7.38 years). Univariate analysis with Log-rank test showed that there were different genders and different ages. Different occupations, different education levels, different clinical stages, different first treatment methods. The survival rates of nasopharyngeal carcinoma patients with different radiotherapy progression were significantly different (P 0.05). The multivariate analysis using Cox proportional risk regression model showed different ages, different genders and different occupations. The survival rates of nasopharyngeal carcinoma patients with different clinical stages and different first treatment methods were significantly different (P 0.05). The main prognostic factors of nasopharyngeal carcinoma were age, sex, occupation and clinical stage. The first treatment. Conclusion: the 5-year survival rate of nasopharyngeal carcinoma inpatients in Hunan Cancer Hospital from 1992 to 2005 was 1 / 3 compared with that of nasopharyngeal carcinoma inpatients from 1987 to 1991. The 5-year survival rate was improved in different degree. The inpatient survival rate of nasopharyngeal carcinoma in this hospital from 1992 to 2005 has reached or exceeded the level of the same grade hospital in China.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R739.63

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