| Hui Peng,Zhimin Liu,Roshan Ara Ghoorun,Xianglin Yuan. Clinical characteristics and survival outcomes of perianal Paget’s disease: A SEER population-based study. Oncol Transl Med, 2020, 6: 1-9. |
| 肛周佩吉特病的临床特点和生存分析：一项基于SEER数据库的研究 |
| Clinical characteristics and survival outcomes of perianal Paget’s disease: A SEER population-based study |
| Received:January 07, 2020 Revised:March 11, 2020 |
| DOI：10.1007/s10330-020-0400-0 |
| 中文关键词: 肛周佩吉特病、乳房外佩吉特病、SEER数据库、生存分析 |
| 英文关键词: perianal Paget’s disease (PPD); extramammary Paget’s disease; SEER database; survival analysis |
| 基金项目:本研究由华中科技大学同济医学院附属同济医院回国人员启动基金和同济医院科研基金支持(No. 2019A16) |
| Author Name | Affiliation | E-mail | | Hui Peng | Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | denice1010@163.com | | Zhimin Liu | Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University (Gastrointestinal and Anal Hospital) | | | Roshan Ara Ghoorun | Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University (Gastrointestinal and Anal Hospital) | | | Xianglin Yuan* | Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | xlyuan1020@163.com |
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| 中文摘要: |
| 目的:
分析肛周佩吉特病(PPD)的临床特点，探讨影响肛周佩吉特病预后的因素。
方法:
通过SEER*Stat软件对美国SEER数据库中1975-2015年116名肛周佩吉特病患者进行分析。采用Kaplan-Meier法对肛周佩吉特病各临床病理因素进行单因素分析；通过Log-Rank 法检验生存率的差别。通过卡方检验比较肛周佩吉特病患者合并肛门直肠癌组和非合并肛门直肠癌组各临床病理特征的差异。
结果:
肛周佩吉特病的患者中位生存时间为44个月，发病的中位年龄73岁，43.10%的病人在随访结束时依然存活，只有12.93%的患者死于佩吉特病。年龄> 70岁(χ2 =9.453, P=0.002)，低分化(χ2 =46.557, P =0.000)和腹会阴切除术(APR) (χ2 =46.557, P =0.000)是肛周佩吉特病预后不良危险因素。本研究中近50%的肛周佩吉特病合并有其它恶性肿瘤，22.41%的患者合并有其它3种及以上的恶性肿瘤，其中48.21%的患者合并肛门直肠恶性肿瘤。卡方检验中肛周佩吉特病患者合并肛门直肠癌组和非合并肛门直肠癌组差异有统计学意义的因素包括：临床分期(χ2=10.127, P =0.018)和手术方式(χ2=12.245, P =0.007)。16.07%的患者患有多个佩吉特病。
结论：
肛周佩吉特病患者生存良好，疾病特定死亡率低。诊断年龄，分化程度和手术方式是肛周佩吉特病患者预后的影响因素。肛周佩吉特病与肛门直肠恶性肿瘤的关系值得关注。 |
| 英文摘要: |
| Objective The aim of the study was to analyze the clinical features of patients with perianal Paget’s
disease (PPD) and investigate prognosis risk factors.
Methods The SEER*Stat software was used to identify 116 PPD patients from 1975 to 2015 in the
SEER research database. The Kaplan-Meier method was used to conduct a univariate analysis for PPD
patients. The differences in survival rates were evaluated using the log-rank test. The differences in the
clinicopathological features of PPD patients with or without anorectal carcinoma were compared using the
chi-square test.
Results The median survival time of PPD patients was 44 months. The median age of onset was 73
years old. The 43.10% of the patients were alive at the end of follow up, and only 12.93% of the patients
died of PPD. Elderly (age > 70 years; χ2 = 9.453, P = 0.002), poor differentiation (χ2 = 46.557, P = 0.000)
and abdominal perineal resection (APR; χ2 = 46.557, P = 0.000) were unfavorable risk factors of prognosis.
Nearly 50% of PPD had combined with other malignancies, and over 22.41% of those had multiple primary
neoplasms (3 or more). PPDs predisposed concurrent malignancy, and 48.21% of PPD patients with other
malignancies combined with anorectal carcinoma in the study. Stage (χ2 = 10.127, P = 0.018), and surgical
method (χ2 = 12.245, P = 0.007) were statistically significant in the PPD patients with or without anorectal
carcinoma. The 16.07% of patients had multiple lesions of Paget’s.
Conclusion Patients with PPD have a favorable survival, while the disease-specific mortality is low.
Diagnosed age, differentiation, and surgical methods were the influence factors of prognosis in PPD
patients. PPDs with anorectal carcinoma is of most important in further investigation. |
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