2010-2017年中国胆囊癌诊治流程与预后分析
王一钧 刘照南 蒲鹏 陶雯琦 颜伟康 央茂 杨明杰 郑志元 邹路 陈涛 陈炜 孙旭恒 耿亚军 何敏 李永盛 王辉 吴文广 杨林华 张军峰 吴向嵩 顾钧 巴桑 冯佳毅 白俊超 蔡鸿宇 曹宏 曹景玉 陈晓亮 崔云甫 戴朝六 党学义 段绍斌 冯健 任泰 顾剑峰 韩玮 郝继辉 何松青 张斌 胡小强 姜小清 金慧涵 李兵 李桂臣 贾子衡 李国松 李明章 李其云 李志臻 刘昌军 刘超 刘付宝 刘建生 刘景丰 刘军 李霖 刘连新 吕文才 聂高华 杞映华 钱叶本 邵成浩 孙备 王传磊 王槐志 王军华 李雪川 王雷 王琳 王琦 王益 王志强 武步强 徐军明 徐民 闫军 杨佳华 刘珂 杨填 喻定刚 袁玉峰 张磊 张启瑜 张彤 张煊 张学利 张学文 赵辉 刘立果 郑进方 朱春富 朱海宏 左石 耿智敏 龚伟 李茂岚 张薇 刘颖斌
中国实用外科杂志2024，Vol.44Issue(9)：1038-1054,1061,18.
中国实用外科杂志2024，Vol.44Issue(9)：1038-1054,1061,18.DOI:10.19538/j.cjps.issn1005-2208.2024.09.14
2010-2017年中国胆囊癌诊治流程与预后分析
Diagnosis,treatment and prognosis of gallbladder cancer in China from 2010 to 2017:a report of 7874 cases
摘要
Abstract
Objective To review,summarize,and discuss the diagnosis,treatment,and prognosis of gallbladder cancer in China between 2010 and 2017.Methods Electronic health records of 7874 patients diagnosed with gallbladder cancer from 49 hospitals were collected and structured from January 2010 to December 2017.Observational indicators included the year of diagnosis,age at first diagnosis,the administrative district of the diagnosing hospital,the rank of the diagnosing hospital,the annual number of gallbladder cancer diagnosed at the diagnosing hospital,sex,ultrasound results,CT results,MRI results,CEA levels,CA19-9 levels,CA125 levels,diagnostic criteria,the timing of diagnosis,whether surgical treatment was received,whether the surgery met the radical treatment standard,TNM staging,and whether adjuvant treatment was received.Quantitative data were tested for normal distribution using the Kolmogorov-Smirnov test,described by mean±standard deviation if normally distributed,and compared using the t-test;non-normally distributed data were described by median(first and third quartiles)and compared using the U-test.Categorical data were described by frequency(percentage of total)and compared using the Chi-squared test.Univariate analysis was performed using logistic regression,and multivariate analysis was conducted using stepwise logistic regression.Overall survival rates were calculated using the life table,survival data were described by median survival time(95％confidence interval),comparisons of overall survival rates between groups at certain time points were conducted using the z-test,and survival curves were plotted using the Kaplan-Meier method,with survival analysis performed using the Log-rank test.Results The number of gallbladder cancer cases has continuously increased over time,with more females than males,and the median diagnosis age is 64 years old.The proportion of patients undergoing enhanced CT,enhanced MRI,tumor marker CEA,CA19-9,and CA125 exams has steadily increased,as has the detection rate of enhanced CT,enhanced MRI,and MRCP.Factors such as age at first diagnosis,sex,the administrative district of the diagnosing hospital,the rank of the diagnosing hospital,the annual number of gallbladder cancer diagnosed at the diagnosing hospital,ultrasound,plain and enhanced CT scans,enhanced MRI scans,MRCP scans,and tumor markers CEA,CA19-9,and CA125 have played a significant role in the early diagnosis of gallbladder cancer.Independent influencing factors for early gallbladder cancer diagnosis include the administrative district of the diagnosing hospital,the rank of the diagnosing hospital,the annual number of gallbladder cancer diagnosed at the diagnosing hospital,sex,enhanced CT scans,and CA125 levels.The median survival time of patients in the study was 334 days,with overall survival rates at six months of 66.0％,one year of 48.0％,two years of 31.3％,three years of 22.2％,and five years of 11.2％,and the survival rates rapidly decreased as tumor TNM stages increased.For patients with resectable gallbladder cancer who underwent radical surgical treatment,the median survival time was 699 days,with overall survival rates at six months of 88.0％,one year of 71.6％,two years of 48.6％,three years of 33.8％,and five years of 17.6％.It's also found that the year of diagnosis,age at first diagnosis,the administrative district of the diagnosing hospital,the rank of the diagnosing hospital,the annual number of gallbladder cancer diagnosed at the diagnosing hospital,preoperative serum tumor markers CEA,CA19-9,CA125 levels,whether surgical treatment was received,whether the surgery met radical treatment standards,and TNM staging had a significant impact on the overall survival time of patients with gallbladder cancer.Conclusion The standardization of diagnosis and treatment for gallbladder cancer in China has greatly improved over time,but the epidemiological characteristics and corresponding causes still require further research.For gallbladder cancer,there is substantial room for improvement in the comprehensive treatment methods and overall survival outcomes,and more attention and effort need to be devoted to the comprehensive treatment.关键词
胆囊恶性肿瘤/术前诊断/外科治疗/综合治疗/流行病学/预后Key words
gallbladder cancer/preoperative diagnosis/surgical treatment/comprehensive treatment/epidemiology/prognosis分类
医药卫生引用本文复制引用
王一钧,刘照南,蒲鹏,陶雯琦,颜伟康,央茂,杨明杰,郑志元,邹路,陈涛,陈炜,孙旭恒,耿亚军,何敏,李永盛,王辉,吴文广,杨林华,张军峰,吴向嵩,顾钧,巴桑,冯佳毅,白俊超,蔡鸿宇,曹宏,曹景玉,陈晓亮,崔云甫,戴朝六,党学义,段绍斌,冯健,任泰,顾剑峰,韩玮,郝继辉,何松青,张斌,胡小强,姜小清,金慧涵,李兵,李桂臣,贾子衡,李国松,李明章,李其云,李志臻,刘昌军,刘超,刘付宝,刘建生,刘景丰,刘军,李霖,刘连新,吕文才,聂高华,杞映华,钱叶本,邵成浩,孙备,王传磊,王槐志,王军华,李雪川,王雷,王琳,王琦,王益,王志强,武步强,徐军明,徐民,闫军,杨佳华,刘珂,杨填,喻定刚,袁玉峰,张磊,张启瑜,张彤,张煊,张学利,张学文,赵辉,刘立果,郑进方,朱春富,朱海宏,左石,耿智敏,龚伟,李茂岚,张薇,刘颖斌..2010-2017年中国胆囊癌诊治流程与预后分析[J].中国实用外科杂志,2024,44(9):1038-1054,1061,18.基金项目
国家自然科学基金项目(No.82273016,No.82303937) （No.82273016,No.82303937）
上海市中央引导地方科技发展专项基金项目(No.YDZX20193100004049) （No.YDZX20193100004049）
