华裔女性生殖系统肿瘤的预后分析: 基于SEER数据库的回顾性研究

目的 利用 SEER 数据库中华裔女性生殖系统肿瘤的患者数据，展开预后因素研究，以指导临床预后判断和治疗决策。 方法 从 SEER 数据库中提取出患者的人口统计学指标，分期指标，肿瘤特征、诊断治疗指标和生存结果。采用 Kaplan-Meier 法构建生存曲线，利用 long-Rank 检验评估曲线之间的统计学差异；并使用VIF 指标，逐步回归对预后因素进行选择，依据选择的重要预后因素，建立 COX 多因素风险回归模型，依据建模结果绘制列线图和 ROC 曲线，从而量化预后因素，进而帮助临床判断和决策。 结果 年龄增加 (OS: HR =7.543 95% CI : 2.672~21.290 P <0.05)，进入更年期 (OS: HR =1.024 95% CI : 0.454~2.312 P <0.05)，无伴侣 (OS: HR =1.273 95% CI : 0.931~1.742 P <0.05)，春秋季发病 (OS: HR =0.532 95% CI : 0.327~0.867 P <0.05)，肿瘤大于6 cm(OS: HR =1.656 95% CI : 1.075~2.551 P <0.05)，未手术治疗 (OS: HR =2.554 95% CI : 0.911~7.159 P <0.05)，AJCC分期为Ⅳ分期 (OS: HR =8.406 95% CI : 5.980~11.816 P <0.05)，病理类型为腺鳞癌 (OS: HR =3.399 95% CI : 1.526~7.571 P <0.05)，肿瘤低分化 (OS: HR =1.228 95% CI : 0.868~1.738 P <0.05), 双侧均发病 (OS: HR =1.513 95% CI : 1.051~2.179 P <0.05) 是降低华裔女性生殖系统常见恶性肿瘤总生存率的独立预后因素。 结论 年龄增加、进入更年期、无伴侣、春秋季发病、肿瘤分化、腺鳞癌、Ⅳ分期、肿瘤过大会增加华裔女性生殖系统恶性肿瘤的死亡风险，有伴侣、接受手术治疗、Ⅰ分期对于生殖系统肿瘤的总体生存状况有一定的保护作用。

Prognostic analysis of reproductive system tumors in ethnic Chinese women: a retrospective study based on SEER database

To guide the clinical prognosis and treatment decision-making. Method Demographic indicators, staging indicators, tumor characteristics, diagnosis and treatment indicators and survival results of patients were extracted from SEER database. Kaplan Meier method was used to construct survival curve, and long rank test was used to evaluate the statistical differences between the curves. Vif index was used to select the prognostic factors step by step. Cox multi factor risk regression model was established according to the selected important prognostic factors, and nomogram and ROC curve were drawn according to the modeling results, so as to quantify the prognostic factors and help the clinical practice Judgment and decision making. Result Age increase(OS:HR=7.543, 95%CI: 2.672-21.290, P<0.05), the menopause(OS:HR=1.024, 95%CI: 0.454-2.312, P<0.05), signal or divorce(OS:HR=1.273, 95%CI: 0.931-1.742,P<0.05), onset in spring and autumn(OS:HR=0.532, 95%CI: 0.327-0.867, P<0.05), tumors larger than 6 cm(OS:HR=1.656, 95%CI: 1.075-2.551, P<0.05), unoperated treatment(OS:HR=2.554, 95%CI: 0.911-7.159,P<0.05), AJCC stage IV(OS:HR=8.406, 95%CI: 5.980-11.816,P<0.05),aden squamous carcinoma(OS:HR=3.399, 95%CI: 1.526-7.571,P<0.05), poorly differentiated tumors(OS:HR=1.228, 95%CI: 0.868-1.738,P<0.05),bilateral onset(OS:HR=1.513, 95%CI: 1.051-2.179,P<0.05) were independent prognostic factors for reducing overall survival of common malignancies of the reproductive system in ethnic Chinese women. Conclusion Increasing age, entering menopause, no partner, onset in spring and autumn, differentiation of tumors, Aden squamous carcinoma, stage IV, excessive tumors increase the risk of death of female reproductive malignancies of ethnic Chinese. Partnering, receiving surgical treatment, and stage I have certain protective effects on the overall survival of reproductive system tumors.