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结直肠癌患者就诊和治疗延迟的影响因素及对预后的影响
作者:冉建朝  周玉兰  郭金萍  朱琳 
单位:新疆医科大学公共卫生学院  新疆 乌鲁木齐 830011 新疆医科大学第三临床医学院  新疆 乌鲁木齐 830011 
关键词:结直肠肿瘤/诊断 结直肠肿瘤/治疗 危险因素 普查 早期诊断 预后 因素分析 统计学 回顾性研究 
DOI:10.13267/j.cnki.syzlzz.2018.06.010
出版年,卷(期):页码:2018,33(6):542-547
摘要:

目的 探讨结直肠癌患者的就诊延迟(symptom to presentation delay,SPD)、治疗延迟(presentation to treatment delay,PTD)及诊治延迟即总延迟(total delay)情况及其对疾病预后的影响。方法 回顾性分析568例行手术治疗的结直肠癌患者的临床资料,分析SPD、PTD和总延迟时间与临床特征的关系,采用Cox单因素及多因素分析影响患者预后的因素。结果 568例结直肠癌患者的中位SPD时间为3.0个月,中位PTD时间为11.0 d,中位总延迟时间为106.0 d。结直肠癌患者的PTD时间在初诊年龄和KPS评分方面比较,差异均具有统计学意义(均P<0.05)。总延迟时间在TNM分期方面比较,差异具有统计学意义(P<0.05)。单因素分析显示,患者预后在PTD、民族、KPS评分、Dukes分期和TNM分期方面比较,差异均具有统计学意义(均P<0.05)。Cox多因素分析显示,PTD是独立的预后风险因素(P<0.05)。结论 结直肠癌患者PTD时间与初诊年龄和KPS评分有关,总延迟时间与TNM分期有关。PTD是结直肠癌预后的独立因素。

Objective To investigate the status of symptom to presentation delay (SPD),presentation to treatment delay (PTD),and delay of diagnosis (total delay) in colorectal cancer patients,as well as the impacts of this status on disease prognosis. Methods The clinical data of 568 patients with colorectal cancer who underwent surgery were retrospectively analyzed.The relationship between SPD,PTD,total delay time and the clinical features of these patients was analyzed.Cox univariate and multivariate analyses were used to analyze the prognostic factors of the disease. Results Among the 568 colorectal cancer patients,the median SPD time was 3.0 months,the median PTD time was 11.0 d,and the total delay time was 106.0 d.The PTD time of these patients was significantly related to the age of diagnosis and KPS score (all P<0.05).Besides,total delay time was found to be significantly related to the TNM stages (P<0.05).Moreover,univariate analysis showed that patients prognosis was statistically influenced by PTD,ethnicity,KPS score,Dukes stage,and TNM stage (all P<0.05).Finally,Cox multivariate analysis suggested that PTD was an independent risk factor of disease prognosis (P<0.05). Conclusion PTD of colorectal cancer patients is related to the age of diagnosis and the KPS score,whereas the total delay time was related to the TNM stages.Moreover,PTD was an independent factor affecting the prognosis of colorectal cancer.

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