Fontana V, Decensi A, Orengo M A, Parodi S, Torrisi R, Puntoni R
Department of Environmental Epidemiology and Biostatistics, IST-National Institute for Cancer Research, Genoa, Italy.
Eur J Cancer. 1998 Mar;34(4):537-42. doi: 10.1016/s0959-8049(97)10098-3.
Survival differences in cancer patients according to socioeconomic status (SES) have been reported for several organs, but the relationship with gastric cancer prognosis has not been conclusively defined. The present study analysed the survival of 122 incident, histologically confirmed gastric cancer patients diagnosed between 1985 and 1987 in Genoa, Italy and enrolled in a multicentric case-control study on gastric cancer occurrence and dietary habits. Adjusting for age at diagnosis, tumour stage, histopathological grading and surgery (i.e. curative gastric resection), Cox's proportional hazards regression model showed statistically significant hazard ratio (HR) (relative risk) estimates below unity for education (> 5 versus < or = 5 years of schooling, HR = 0.40, P = 0.003) and occupation (higher versus lower income job, HR = 0.59, P = 0.030). Also, the same final regression model revealed a positive prognostic effect for origin (Southern Italy migrants versus Genoa natives) (HR = 0.56, P = 0.039) and female gender (HR = 0.58, P = 0.020). High SES, origin from lower risk area for gastric cancer occurrence and female gender are positive prognostic categories for gastric cancer patients.
已有报道称，不同器官的癌症患者生存率因社会经济地位（SES）而异，但SES与胃癌预后的关系尚未明确界定。本研究分析了1985年至1987年间在意大利热那亚确诊的122例组织学确诊的新发胃癌患者的生存情况，这些患者参与了一项关于胃癌发生与饮食习惯的多中心病例对照研究。在调整了诊断年龄、肿瘤分期、组织病理学分级和手术（即根治性胃切除术）后，Cox比例风险回归模型显示，受教育程度（>5年与≤5年学校教育，风险比[HR]=0.40，P=0.003）和职业（高收入工作与低收入工作，HR=0.59，P=0.030）的风险比估计值在统计学上显著低于1。此外，同一最终回归模型显示，籍贯（意大利南部移民与热那亚本地人）（HR=0.56，P=0.039）和女性性别（HR=0.58，P=0.020）具有积极的预后作用。高社会经济地位、来自胃癌发生低风险地区以及女性性别是胃癌患者的积极预后类别。
