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胃癌预后因素的Cox比例风险模型与逻辑回归比较。

A comparison between Cox proportional hazard models and logistic regression on prognostic factors in gastric cancer.

作者信息

Moghimi-Dehkordi B, Safaee A, Tabei S Z

机构信息

Research Center for Gastroenterology and Liver Diseases, Shaheed Beheshti University (M.C), Tehran, Iran.

出版信息

East Afr J Public Health. 2009 Apr;6 Suppl(1):20-2. doi: 10.4314/eajph.v6i3.45766.

Abstract

BACKGROUND

Despite its decreasing prevalence in industrialized nations, gastric cancer remains one of the most frequent cancers in the world. Since stomach cancer often was not detected until an advanced state, survival rate was rather low.

AIM

The aim of the present study is to compare the Cox proportional hazard model and Logistic regression model to estimate prognostic of patients with gastric cancer.

MATERIAL AND METHODS

To determine the independent prognostic factors reducing survival time for gastric cancer, we compared the parametric methods (logistic regression) and non-parametric methods (Cox proportional hazard models) applied to patients who registered in one cancer registry center located in southern Iran.

RESULTS

Of 442, 266 (60.2 %) died. In multivariate analyses using the Cox proportional hazard model, Age at diagnosis (P = 0.018, Hazard rate = 1.84), grade of tumor (P = 0.018, Hazard rate = 1.56), and metastasis (P = 0.004, Hazard rate = 1.53) were the most independent prognostic factors. As well as, using the stepwise logistic regression model, Age at diagnosis, (P = 0.005, Odds Ratio = 1.01), grade of tumor (P = 0.025, OR = 1.95), and metastasis (P < 0.001, OR = 2.81) were also the most independent factors who affected on survival.

CONCLUSION

Although regression coefficients are not all the same, these three factors are the most prognostic factors that affect on survival of gastric patients in both multivariate analyses.

摘要

背景

尽管胃癌在工业化国家的发病率呈下降趋势,但它仍是全球最常见的癌症之一。由于胃癌往往在晚期才被发现,其生存率相当低。

目的

本研究旨在比较Cox比例风险模型和逻辑回归模型,以评估胃癌患者的预后。

材料与方法

为了确定影响胃癌患者生存时间的独立预后因素,我们比较了应用于伊朗南部一家癌症登记中心登记患者的参数方法(逻辑回归)和非参数方法(Cox比例风险模型)。

结果

442例患者中,266例(60.2%)死亡。在使用Cox比例风险模型的多变量分析中,诊断时年龄(P = 0.018,风险率 = 1.84)、肿瘤分级(P = 0.018,风险率 = 1.56)和转移情况(P = 0.004,风险率 = 1.53)是最主要的独立预后因素。同样,在逐步逻辑回归模型中,诊断时年龄(P = 0.005,比值比 = 1.01)、肿瘤分级(P = 0.025,比值比 = 1.95)和转移情况(P < 0.001,比值比 = 2.81)也是影响生存的最主要独立因素。

结论

尽管回归系数不尽相同,但在这两种多变量分析中,这三个因素都是影响胃癌患者生存的最重要预后因素。

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