【摘要】 目的应用病案信息系统中的临床数据研究结直肠癌异时远处转移的影响因素。方法依托某三级医院的病案信息系统,选择2013年1月1日-2017年12月31日首次确诊为结直肠癌且未发生远处转移的1491例患者构建纵向观察队列。采用Cox比例风险回归模型分析结直肠癌异时远处转移的影响因素。结果经过中位随访时间5.7月(0.13月～62.8月)有191人发生远处转移,转移最常发生的部位为肝脏,肝转移发生率为6.71%。单因素Cox比例风险回归模型结果显示年龄、肿瘤直径、肿瘤面积、CEA、CA125、CA199和CA724、肿瘤大体分型、分化程度、组织学分型、T分期、N分期是结直肠癌患者发生远处转移的危险因素。多因素Cox比例风险回归模型显示年龄(HR=0.968,95%CI:0.940-0.997)、CEA(HR=1.003,95%CI:1.001-1.005)和CA199(HR=1.002,95%CI:1.001-1.004)是结直肠癌患者发生远处转移的影响因素。结论病案信息系统在临床科研中具有重要的作用,年龄、CEA和CA199是结直肠癌异时远处转移的影响因素。更多还原

【Abstract】 Objectives To identify possible influencing factors of developing metachronous metastases of colorectal cancer using clinical data in medical record information system. Methods From the medical record information system, patients diagnosed with colorectal carcinoma for the first time without metastases from January 1st, 2013 to December 31st, 2017 were selected. Totally, 1491 patients were included in our cohort study. A Cox model was used to analyze the risk of developing a metachronous metastasis. Results After a median 5.7(0.13-62.8) months follow-up, 191 cases initially diagnosed with developing metastatic disease. The most common site of metastasis was liver, and the liver metastasis rate was 6.71%. Univariate analysis identified that age, tumor diameter, tumor size, carcinoembryonic antigen(CEA), carbohydrate antigen(CA) 125, CA199 and CA 724, tumor gross classification, differentiation degree, tissue type, T staging, N staging were the risk factors of developing metastatic disease. Multivariate Cox proportional hazards regression model showed age(HR=0.968, 95%CI:0.940-0.997), CEA(HR=1.003,95%CI:1.001-1.005), and CA199(HR=1.002,95% CI:1.001-1.004) were the influencing factors of developing metastatic disease. Conclusions The medical record information system played an important role in clinical research. Age, CEA and CA199 were the factors affecting developing metachronous metastases of colorectal cancer.更多还原