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標題: | 應用網基版存活分析工具分析 Statin 類藥物對肺癌手術切除後復發風險影響之回溯性研究 A Retrospective Study on the Association of Statin Use with Recurrence Risk in Lung Cancer Patients after Surgical Resection using Web-based Survival Analysis Tools |
作者: | Chin-Jung Hsieh 謝競容 |
指導教授: | 賴飛羆 |
關鍵字: | 肺癌,存活分析,復發,藥物, Lung cancer,Survival analysis,Recurrence,Medication, |
出版年 : | 2019 |
學位: | 碩士 |
摘要: | 近幾年來,不僅僅是在台灣,肺癌也一直居於全球癌症死亡之首。而針對初期肺癌病患,在眾多的治療方式中,手術切除是最常見的,化療藥物治療與標靶藥物治療亦是常見的治療方式;然而,化療藥物的副作用與標靶藥物的價格卻常常使病患卻步,且兩者的治療效果也未必能如預期般良好。因此,除了化療藥物與標靶藥物,其他副作用較緩和且價格較低廉的藥物,對肺癌病患術後的復發有何影響,是值得我們探討的。
隨著科技的進步,對於病人電子病歷資料的擷取,現今已發展出相當純熟的技術。有別於過去病人資料的收集方式,自動化的資料收集方式不僅能減少收集所需時間,擷取到的資料也會比以往還要精確。臺大醫院院內的藥品安全監視系統能夠依照診斷碼及藥品碼找到相關病患,然而尚缺乏依手術處置碼尋找病患之功能,在經過我們對系統程式的修改後,現已能夠有效率地找出曾接受過特定手術的病患。 將病患的用藥資訊加入資料集之後,對於這些肺癌病患的復發分析,則可以使用SMART系統。SMART系統是基於網頁建立的工具,在將病患資料匯入SMART網頁且依我們的目的篩選資料後,SMART隨即能對該資料集進行分析。病患的相關描述性統計會以表格方式呈現,復發情況則會以曲線圖與表格的方式呈現。有了方便使用者操作的圖形化介面,以往運算量龐大且複雜的存活分析將簡化許多。 在針對五種不同藥品對病人做復發分析後,我們發現Statin類藥品對術後的肺癌病人會有保護效果,且和未使用該藥品之病人的復發情形有統計上顯著之差異。上述系統的結合可以應用於肺癌病人術後之照護,並輔助醫師判讀不同藥物對於癌症復發是否有保護效果。 In recent years, lung cancer has been listed as the leading cause of cancer deaths not only in Taiwan but also around the world. For early lung cancer cases, operation is the most common treatment, and chemotherapy and targeted therapy are also popular treatment choices. However, side effects of chemotherapy and the high prices of targeted therapies often frighten off the patients. Also, the effects of chemo- and targeted therapies are not as good as expected. Consequently, the protective effect of other common medicines with fewer side effects and lower prices on the recurrence of lung cancer after surgical curative resection is worth our exploring. With the development of clinical medication information system, there have been more and more convenient tools aiming to perform electronic record extraction, which would cost much less time and achieve higher accuracy while comparing to traditional extraction methods. National Taiwan University Hospital Clinical Surveillance System (NCSS) is capable of retrieving electronic records according to diagnosis codes or medication codes. After we built a new module for operation data extraction, NCSS is able to search for patients in a more efficient and comprehensive way. Next, we used Survival Metadata Analysis Responsive Tool (SMART) to perform the recurrence analysis after adding the medication information into the dataset. SMART, a web-based tool, is able to analyze the data right after data import and output different kinds of tables, charts, and survival curves. Thanks to SMART, the complicated survival analysis process is simplified. After the recurrence analysis on the patients with regard to five kinds of medicines, we found that the risk of recurrence in patients with Statin prescriptions was significantly lower than that in patients without Statin prescriptions. With the combination of NCSS and SMART, we can not only improve the health care of lung cancer patients after surgery but also help doctors estimate the protective effect of different kinds of medicines on recurrence. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/7596 |
DOI: | 10.6342/NTU202000003 |
全文授權: | 同意授權(全球公開) |
電子全文公開日期: | 2030-01-02 |
顯示於系所單位: | 資訊工程學系 |
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ntu-108-1.pdf 此日期後於網路公開 2030-01-02 | 5.17 MB | Adobe PDF |
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