Liu Qi, Zhang Ruoxin, Li Qingguo, Li Xinxiang
Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Front Oncol. 2021 Jul 7;11:677198. doi: 10.3389/fonc.2021.677198. eCollection 2021.
To evaluate the clinical implications of non-biological factors (NBFs) with colorectal cancer (CRC) patients younger than 45 years.
In the present study, we have conducted Cox proportional hazard regression analyses to evaluate the prognosis of different prognostic factors, the hazard ratios (HRs) were shown with 95% confidence intervals (CIs). Kaplan-Meier method was utilized to compare the prognostic value of different factors with the log-rank test. NBF score was established according to the result of multivariate Cox analyses.
In total, 15129 patients before 45 years with known NBFs were identified from the SEER database. Only county-level median household income, marital status and insurance status were NBFs that significantly corelated with the cause specifical survival in CRC patients aged less than 45 years old (P < 0.05). Stage NBF 1 showed 50.5% increased risk of CRC-specific mortality (HR = 1.505, 95% CI = 1.411-1.606, P < 0.001). Stage NBF 0 patients were associated with significantly increased CRC-specific survival (CCSS) when compared with the stage NBF 1 patients in different AJCC TNM stages.
NBF stage (defined by county-level median household income, marital status and insurance status) was strongly related to the prognosis of CRC patients. NBFs should arouse enough attention of us in clinical practice of patients younger than 45 years.
评估非生物学因素(NBFs)对45岁以下结直肠癌(CRC)患者的临床意义。
在本研究中,我们进行了Cox比例风险回归分析以评估不同预后因素的预后情况,风险比(HRs)以95%置信区间(CIs)表示。采用Kaplan-Meier法和对数秩检验比较不同因素的预后价值。根据多变量Cox分析结果建立NBF评分。
从SEER数据库中总共识别出15129例45岁以下已知NBFs的患者。在45岁以下的CRC患者中,只有县级家庭收入中位数、婚姻状况和保险状况这些NBFs与特定病因生存率显著相关(P<0.05)。NBF 1期显示结直肠癌特异性死亡风险增加50.5%(HR = 1.505,95%CI = 1.411 - 1.606,P<0.001)。在不同的美国癌症联合委员会(AJCC)TNM分期中,与NBF 1期患者相比,NBF 0期患者的结直肠癌特异性生存率(CCSS)显著提高。
NBF分期(由县级家庭收入中位数、婚姻状况和保险状况定义)与CRC患者的预后密切相关。在45岁以下患者的临床实践中,NBFs应引起我们足够的重视。