鼻咽癌特征和存活率的种族差异

De Yu, Hai-Bo Xu, Gui-Ping Chen, San-Gang Wu
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摘要

目的调查并比较美籍华人、非西班牙裔白人和非裔美国人鼻咽癌(NPC)患者的组织学亚型分布、发病分期和生存结果。材料和方法:我们确定了 2010 年至 2017 年期间确诊的华裔美国人、非西班牙裔白人和非裔美国人鼻咽癌患者。采用卡方检验、倾向得分匹配、卡普兰-梅耶尔分析和多变量考克斯比例危险模型进行统计分析。结果共纳入了1646名符合条件的鼻咽癌患者。非西班牙裔白人有 1049 人(占 63.7%),非裔美国人有 265 人(占 16.1%),华裔美国人有 332 人(占 20.2%),他们确诊时的中位年龄分别为 59 岁、55 岁和 53 岁(P < .001)。与非西班牙裔白人(n = 164,15.6%)或非裔美国人(n = 44,16.7%)相比,华裔美国人最常罹患未分化非角化鳞状细胞癌亚型(n = 134,40.4%)(P < .001)。非西班牙裔白人和非裔美国人患者的组织学亚型分布相似(P = .338)。与非西班牙裔白人患者(n = 704,67.1%)和华裔美国人患者(n = 210,63.2%)相比,非裔美国人患者的 III 至 IV 期疾病比例最高(n = 206,77.7%)(P = .009)。美籍华人和非西班牙裔白人患者的分期分布无明显差异(P = .494)。与美籍华人患者相比,非西班牙裔白人患者(危险比 (HR) 1.344,95% 置信区间 (CI) 1.007-1.479,P = .045)和非裔美国人患者(HR 2.314,95% CI 1.405-3.813,P < .001)的总生存率明显较低。但是,在多变量分析中,种族与鼻咽癌特异性生存率无关。倾向得分匹配后也发现了类似的结果。结论:种族会影响鼻咽癌的组织学亚型分布、发病分期和生存结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Racial Disparities in Nasopharyngeal Carcinoma Characteristics and Survival.

Objective: To investigate and compare the distribution of histological subtypes, stage at presentation, and survival outcomes among Chinese American, Non-Hispanic White, and African American patients with nasopharyngeal carcinoma (NPC). Materials and methods: We identified Chinese American, Non-Hispanic White, and African American patients with NPC who were diagnosed between 2010 and 2017. Statistical analyses were conducted using the chi-square test, propensity score matching, Kaplan-Meier analysis, and multivariate Cox proportional hazards models. Results: A total of 1646 eligible patients with NPC were included. Non-Hispanic White accounted for 1049 (63.7%), African Americans for 265 (16.1%), and Chinese Americans for 332 (20.2%), and their median age at diagnosis was 59, 55, and 53 years, respectively (P < .001). Chinese Americans most frequently harbored undifferentiated non-keratinizing squamous cell carcinoma subtype (n = 134, 40.4%) than Non-Hispanic White (n = 164, 15.6%) or African American patients (n = 44, 16.7%) (P < .001). Histological subtype distribution was similar between Non-Hispanic White and African American patients (P = .338). African American patients had the highest rate of stage III to IV disease (n = 206, 77.7%) compared to Non-Hispanic White (n = 704, 67.1%) and Chinese American patients (n = 210, 63.2%) (P = .009). No significant difference in stage distribution was observed between Chinese American and Non-Hispanic White patients (P = .494). Non-Hispanic White patients [hazard ratio (HR) 1.344, 95% confidence interval (CI) 1.007-1.479, P = .045] and African American patients (HR 2.314, 95% CI 1.405-3.813, P < .001) had significantly worse overall survival compared to Chinese American patients. However, race was not associated with NPC-specific survival in the multivariate analysis. Similar results were found after propensity score matching. Conclusions: Race influences the distribution of histological subtypes, stage at presentation, and survival outcomes in NPC.

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