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Establishment of A Colon Cancer Database at Peking Union Medical College Hospital: A Single-center Database Experience
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摘要:
目的 通过整理北京协和医院结肠癌专病数据库建立以来结肠癌患者的临床资料，展示条目信息缺失情况及随访率数据，以期为单中心数据库的建立提供借鉴。 方法 收集北京协和医院结肠癌专病数据库中2016年1月5日至2022年5月11日期间行手术治疗结肠癌患者的临床资料，包括基本信息、原发灶特征、手术与病理信息及术后并发症等33个条目，计算各条目缺失率和患者随访率。 结果 共入选符合纳入和排除标准的1682例结肠癌患者。其中男性981例，女性701例；平均年龄(62.75±11.97)岁；术后并发症发生率为15.6%(263/1682)。该数据库包含的条目信息中，患者性别、年龄、民族等基本信息及病理分期信息均登记完全无缺失；而病变部位(12.2%)、免疫组化错配修复状态(8.0%)缺失率相对较高。33个条目的缺失率分布于0~12.2%，其中缺失率＜1%的条目占比81.8%(27/33)，缺失率＜5%的条目占比93.9%(31/33)。随访率方面，完全失访的患者仅占比1.7%，即具备随访信息患者的比例为98.3%；2020年7月2日前入组患者(由于数据库迁移的原因，该日期后入组的患者不具有统一格式的定期随访信息)的第1、2、3、4、5年随访率分别为55.02%、70.96%、72.02%、65.42%、70.91%，2年完全随访率为19.5%。 结论 北京协和医院结肠癌专病数据库条目缺失率较低，几乎所有患者均具有随访信息，整体数据质量较高，具有一定参考价值，但连续随访率仍存在较大的提升空间。 Abstract:Objective By collecting the patient information in the Colon Cancer Database of Peking Union Medical College Hospital since its establishment, we aim to demonstrate the completeness of the clinicopathological characteristics and follow-up data to provide reference for single-center database establishment. Methods We collected 33 surgical patient information entries from the single-center prospective registry database of Colon Cancer at Peking Union Medical College Hospital from January 5, 2016 to May 11, 2022, including demographic characteristics, features of the primary lesion, surgical and pathological information and postoperative complications, and calculated the missing rate of each entry as well as the follow-up data. Results A total of 1682 patients with colon cancer were included in the analysis, in which 981 patients were male and 701 patients were female, with an average age of (62.75±11.97) years. The postoperative complication rate was 15.6% (263/1682). Among the data entries, demographic features such as sex, age, ethnic group as well as the pathologic staging were collected without missing. The relatively high-missing entries were the colonoscopy tumor site with a missing rate of 12.2%, followed by immunohistochemical information of mismatch repair with a missing rate of 8.0%. The missing rate of all 33 entries was distributed in 0-12.2%, of which 81.8% (27/33) were less than 1% and 93.9% (31/33) were less than 5%. As for follow-up data, the percentage of patients with complete missing follow-up was 1.7%, which meant 98.3% patients had available survival data. The 1-year, 2-year, 3-year, 4-year and 5-year follow-up rates of patients enrolled before July 2, 2020 (patients enrolled after this date did not have regular follow-up information in a uniform format due to data migration) were 55.02%, 70.96%, 72.02%, 65.42% and 70.91%, respectively, and the 2-year complete follow-up rate was 19.5%. Conclusion The low rate of missing statistical entries and the high follow-up rate of our center's database has certain reference value for database establishment, but there is still room for improvement in terms of continuous follow-up. -
Key words:
- colon cancer /
- database /
- follow-up /
- tumor
作者贡献：李珂璇、孙振负责数据收集与整理、统计分析及论文撰写；肖毅负责研究设计与论文修订；邱辉忠、吴斌、林国乐、陆君阳、孙曦羽、牛备战、徐徕负责数据质控。利益冲突：所有作者均声明不存在利益冲突 -
表 1 1682例结肠癌患者基本资料及原发灶特征登记情况
指标 数值 男性[n(%)] 981(58.3) 年龄(x±s, 岁) 62.75±11.97 汉族[n(%)] 1600(95.1) 婚姻状态[n(%)] 已婚 1581(94.0) 离婚/丧偶/未婚/其他 99(5.9) 缺失 2(0.1) BMI(x±s, kg/m2)* 23.68±3.46 手术年份[n(%)] 2016年 266(15.8) 2017年 324(19.3) 2018年 167(9.9) 2019年 232(13.8) 2020年 211(12.5) 2021年 338(20.1) 2022年 142(8.4) 缺失 2(0.1) ASA分级[n(%)] Ⅰ 377(22.4) Ⅱ 1078(64.1) Ⅲ 178(10.6) Ⅳ 3(0.2) 缺失 46(2.7) 原发灶数量[n(%)] 多发 52(3.1) 单发 1623(96.5) 缺失 7(0.4) 病变部位[n(%)] 回盲部 152(9.0) 升结肠 317(18.8) 结肠肝区 167(9.9) 横结肠 141(8.4) 结肠脾曲 45(2.7) 降结肠 118(7.0) 乙状结肠 496(29.5) 直肠乙状结肠交界 31(1.8) 多节段 9(0.5) 缺失 206(12.2) *缺失11例(0.7%)；BMI：同图 2；ASA：美国麻醉医师协会 
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表 2 1682例结肠癌患者手术相关信息登记情况[n(%)]
指标 数值 术前化疗 有 83(4.9) 无 1594(94.8) 缺失 5(0.3) 术式 右半结肠癌根治术(CME/D2) 736(43.8) 横结肠癌根治术 51(3.0) 左半结肠癌根治术 188(11.2) 乙状结肠癌根治术/Dixon术 647(38.5) Hartmann术 11(0.7) 仅肠造口术 1(0.1) 多节段/全结肠切除术 20(1.2) 缺失 28(1.7) 手术类型 腹腔镜 1603(95.3) 开腹 38(2.3) 中转开腹 34(2.0) 缺失 7(0.4) 联合脏器切除 无 1573(93.5) 有 108(6.4) 缺失 1(0.1)
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表 3 1682例结肠癌患者术后病理信息登记情况[n(%)]
指标 数值 粘液腺癌 是 281(16.7) 否 1401(83.3) 印戒细胞癌 是 32(1.9) 否 1650(98.1) 低分化腺癌 是 176(10.5) 否 1491(88.6) 缺失 15(0.9) T分期 T1 107(6.4) T2 218(13.0) T3 997(59.3) T4a 325(19.3) T4b 35(2.1) N分期 N0 980(58.3) N1a 213(12.7) N1b 210(12.5) N1c 66(3.9) N2a 126(7.5) N2b 87(5.2) M分期 M0 1563(92.9) M1a 82(4.9) M1b 10(0.6) M1c 26(1.5) M1(具体不详) 1(0.1) 环周切缘 阴性 1667(99.1) 阳性 9(0.5) 缺失 6(0.4) 脉管瘤栓 阳性 473(28.1) 阴性 1173(69.7) 缺失 36(2.1) 神经侵犯 阳性 213(12.7) 阴性 1418(84.3) 缺失 51(3.0) 免疫组化MMR状态 pMMR 1295(77.0) dMMR 252(15.0) 缺失 135(8.0) TNM分期 Ⅰ 270(16.1) ⅡA 553(32.9) ⅡB 113(6.7) ⅡC 12(0.7) ⅢA 44(2.6) ⅢB 459(27.3) ⅢC 112(6.7) ⅣA 82(4.9) ⅣB 10(0.6) ⅣC 26(1.5) Ⅳ(具体不详) 1(0.1) MMR：错配修复
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表 4 1068例结肠癌患者随访率信息
随访时间 无瘤生存(n) 带瘤生存(n) 死亡(n) 缺失(n) 满随访期患者数目(n) 随访率(%) 第0.5年 480 60 3 525 1068 50.84 第1年 524 52 10 482 1065 55.02 第1.5年 570 81 10 407 1055 62.65 第2年 643 72 18 335 1033 70.96 第2.5年 552 69 18 429 951 67.19 第3年 517 59 16 476 822 72.02 第3.5年 458 45 5 560 694 73.20 第4年 395 39 3 631 668 65.42 第4.5年 340 31 2 695 587 63.54 第5年 256 16 1 795 385 70.91 第5.5年 46 2 0 1020 299 16.05
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