【摘要】 目的 基于SEER数据库比较肛管鳞癌与腺癌患者的临床特征，探讨影响肛管鳞癌患者预后的危险因素。方法 提取SEER数据库中2004—2010年符合条件的1 413例肛管鳞癌和111例肛管腺癌患者资料，比较二者的临床特征及预后。采用Kaplan-Meier法绘制肛管鳞癌各亚组的生存曲线，采用Cox比例风险模型评估预后影响因素。结果 肛管鳞癌与腺癌患者的T分期、N分期分布比较，差异无统计学意义（P>0.05）；两组的年龄、性别、种族、分化程度、分期、M分期、手术、放化疗情况比较，差异有统计学意义（P<0.05）。肛管鳞癌和肛管腺癌患者的中位生存时间分别为134.5个月和40.7个月，5年生存率分别为62%和37%,10年生存率分别为50%和23%。肛管鳞癌患者的中位生存时间长于肛管腺癌患者，5年及10年生存率高于肛管腺癌患者，差异有统计学意义（P<0.05）。Cox多因素分析显示，年龄、性别、TNM分期、化疗是影响患者预后的独立因素（P<0.05）。结论 肛管鳞癌预后较优于肛管腺癌，应根据影响预后的因素，如年龄、性别、TNM分期、化疗，对患者进行个体化干预。更多还原

【Abstract】 Objective The clinical characteristics of patients with anal squamous cell carcinoma and adenocarcinoma were compared based on SEER database, and the risk factors affecting the prognosis of patients with anal squamous cell carcinoma were discussed. Methods The data of 1 413 patients with anal squamous cell carcinoma and 111 patients with anal adenocarcinoma were extracted from SEER database from 2004 to 2010, and the clinical characteristics and prognosis of the two patients were compared. Kaplan-Meier method was used to draw the survival curve of each subgroup of anal squamous cell carcinoma, and Cox proportional risk model was used to evaluate the prognostic factors. Results There were no significant differences in T stage and N stage distribution between patients with anal squamous cell carcinoma and adenocarcinoma(P>0.05). There were statistically significant differences in age, sex, race, degree of differentiation, stage, M stage, operation, radiotherapy and chemotherapy between the two groups(P<0.05). The median survival time of patients with anorectal squamous cell carcinoma and anorectal adenocarcinoma was 134.5 months and 40.7 months, respectively. The5-year survival rates were 62% and 37%, and the 10-year survival rates were 50% and 23%, respectively. The median survival time of patients with anal squamous cell carcinoma was longer than that of patients with anal adenocarcinoma, and the 5-year and 10 year survival rates were higher than those of patients with anal adenocarcinoma, with statistical significances(P<0.05). Cox multivariate analysis showed that age, gender, TNM stage and chemotherapy were independent factors affecting the prognosis of patients(P<0.05). Conclusion The prognosis of anorectal squamous cell carcinoma is better than that of anorectal adenocarcinoma, and individualized intervention should be carried out according to the factors affecting prognosis, such as age, gender, TNM stage and chemotherapy.更多还原