摘要
目的分析当前版本华西肠癌数据库(Database from Colorectal Cancer,DACCA)中结直肠癌新辅助治疗的细节与疗效。方法本次数据分析选取的DACCA版本为2020年7月28日更新版,其中新辅助治疗细节模块的数据项目包括新策(新辅助拟定方案)、新依(患者对新辅助治疗的依从性)和新辅强度方案,其中新策包括新辅助策略准确度和是否纳入科研,新辅助强度方案包括新辅助治疗中是否化疗、化疗周期数、是否使用靶向药物和是否放疗。新辅助疗效模块的数据项目包括初期和辅后CEA、癌标变化、症状变化、大体变化、影像变化和病理肿瘤衰退分级(TRG)。对所选的数据项目进行统计学分析。结果本研究符合筛选条件的数据病案(数据行)总量为7513条,其中新辅助策略准确度的有效数据2539条(33.8%),曾被纳入科研的有效数据498条(6.6%);新依的有效数据637条(8.5%),接受化疗的有效数据2077条(27.6%),化疗周期的有效数据614条(8.2%),曾使用靶向药物的有效数据455条(6.1%),接受放疗的有效数据135条(1.8%),初期CEA的有效数据5022条(66.8%),辅后CEA的有效数据818条(10.9%),癌标变化的有效数据614条(8.2%),症状变化的有效数据464条(6.2%),大体变化的有效数据478条(6.4%),影像变化的有效数据492条(6.5%),病理TRG的有效数据459条(6.1%)。癌标变化与大体变化(χ^(2)=6.26,P=0.02),症状变化与大体变化、影像变化和病理TRG(χ^(2)=53.71,P<0.01;χ^(2)=38.41,P<0.01;χ^(2)=8.68,P<0.01),大体变化与影像变化和病理TRG(χ^(2)=44.41,P<0.01;χ^(2)=100.37,P<0.01),以及影像变化和病理TRG(χ^(2)=31.52,P<0.01)之间有相关性。结论新辅助治疗方案的选择存在着巨大的完善空间,DACCA数据库能为愿意选择新辅助化疗的结直肠癌专科医生提供数据支撑。新辅助治疗的疗效指标之间存在联系,明确各疗效之间的确切关系能为疗效预测模型的建立提供更有价值的信息。
Objective To analyze the details and efficacy of neoadjuvant therapy of colorectal cancer in the current version of Database from Colorectal Cancer(DACCA).Methods The DACCA version selected for this data analysis was the updated version on July 28 th,2020.The data items included"planned strategy of neoadjuvant therapy""compliance of neoadjuvant therapy",and"cycles of neoadjuvant therapy".Item of"planned strategy of neoadjuvant therapy"included"accuracy of neoadjuvant therapy"and"once included in researches".Item of"the intensity of neoadjuvant therapy"included"chemotherapy""cycles of neoadjuvant therapy""targeted drugs",and"neoadjuvant radiotherapy".Item of"effect of neoadjuvant therapy"included CEA value of"pre-neoadjuvant therapy"and"postneoadjuvant therapy""variation of tumor markers""variation of symptom""variation of gross""variation of radiography",and tumor regression grade(TRG).The selected data items were statistically analyzed.Results The total number of medical records(data rows)that met the criteria was 7513,including 2539(33.8%)valid data on the"accuracy of neoadjuvant therapy",498(6.6%)valid data on"once included in researches",637(8.5%)valid data on the"compliance of neoadjuvant therapy",2077(27.6%)valid data on"neoadjuvant chemotherapy",614(8.2%)valid data on"cycles of neoadjuvant therapy",455(6.1%)valid data on"targeted drugs",135(1.8%)valid data on"neoadjuvant radiotherapy",5022(66.8%)valid data on"pre-neoadjuvant therapy CEA value",818(10.9%)valid data on"postneoadjuvant therapy CEA value",614(8.2%)valid data on"variation of tumor marker",464(6.2%)valid data on"variation of symptom",478(6.4%)valid data on"variation of gross",492(6.5%)valid data on"variation of radiography",and 459(6.1%)valid data on TRG.During the correlation analysis,it appeared that"variation of tumor marker"and"variation of gross"(χ^(2)=6.26,P=0.02),"variation of symptom"and"variation of gross","radiography"and TRG(χ^(2)=53.71,P<0.01;χ^(2)=38.41,P<0.01;χ^(2)=8.68,P<0.01),"variation of gross"and"variation of radiography",
作者
刘勇
汪晓东
由屹先
余可欣
李立
周总光
LIU Yong;WANG Xiaodong;YOU Yixian;YU Kexin;LI Li;ZHOU Zongguang(Department of Gastrointestinal Surgery,West China Hospital of Sichuan University,Chengdu 610041,P.R.China;West China School of Medicine,Sichuan University,Chengdu 610041,P.R.China)
出处
《中国普外基础与临床杂志》
CAS
2021年第5期657-663,共7页
Chinese Journal of Bases and Clinics In General Surgery
基金
四川大学华西医院临床研究孵化项目(项目编号:2021HXFH052)。
关键词
结直肠癌
数据库
大数据
新辅助治疗
医疗质量
colorectal cancer
database
big data
neoadjuvant therapy
medical quality
