食管癌患者肿瘤最长径与浸润深度和淋巴结转移的关系及其对生存期的影响  

Relationship of Tumor Length and Invasion and Lymph Node Metastasis and Relevant Risk Factors on Survival of Esophageal Squamous Cell Carcinoma Patients

作　　者：崔纪丽[1,2] 侯志超[1] 刘玉[1] 彭秀青[1,3] 李燕[1] 郭二涛[1] 袁果[1,2] 陈莉莎[1,2] 黄佳 杜丹凤[4] 王立东 

机构地区：[1]河南省食管癌重点开放实验室郑州大学第一附属医院,郑州450052 [2]新乡医学院癌症研究中心 [3]河南科技大学第一附属医院肿瘤科 [4]三全医学院

出　　处：《肿瘤防治研究》2014年第3期214-220,共7页Cancer Research on Prevention and Treatment

基　　金：国家科技部863重大资助项目(2012AA02A503)

摘　　要：目的探讨16 370例食管癌患者肿瘤最长径与浸润程度和淋巴结转移的关系及对生存期的影响。方法通过入户或者电话问卷调查及生存随访,核查食管癌患者信息,采用卡方检验、秩和检验、Spearman相关分析、Kaplan-Meier生存曲线,Log rank检验和Cox生存分析模型,回顾性分析1995—2011年太行高发区普查食管癌患者肿瘤最长径与浸润程度(T分期)和淋巴结转移的关系及其对生存期的影响。结果 (1)随着浸润程度加深,肿瘤最长径依次增长(P<0.001);肿瘤最长径<3 cm的患者淋巴结转移阳性率明显低于≥3 cm的患者(P<0.001);肿瘤最长径与浸润程度及淋巴结阳性转移率正相关(RT=0.379,RN=0.213,P<0.001);(2)肿瘤最长径≥3 cm患者生存期明显差于<3 cm患者(P<0.001)。多因素分析提示,肿瘤最长径、性别、诊断年龄、浸润程度、淋巴结转移、大体类型、分化程度、肿瘤部位均是影响患者生存期的独立因素(P<0.05)。结论随着肿瘤最长径增长、浸润程度加深,淋巴结转移阳性率明显升高;食管癌肿瘤长径是影响食管癌患者生存期的独立因素。Objective To investigate the relationship between tumor length(TL) and invasion(T-stage) and lymph node metastasis and survival in esophageal squamous cell carcinoma(ESCC) patients. Methods The questionnaire, home interview and / or telephone were performed for follow-up. The Chi-square test, Nonparametric test, Spearman Correlation, Kaplan-Meier survival analysis and multivariate Cox regression model were applied to assess the association between TL, invasion and lymph node metastasis and survival of ESCC in high-incidence areas of Tai-hang from 1995 to 2011. Results(1) With the infi ltration increasing, the largest diameter of tumor enhanced(P <0.001); lymph node metastasis in patients with maximum tumor diameter <3 cm was signifi cantly lower than that in patients ≥3 cm(P <0.001); tumor maximum diameter and depth of invasion were positively correlated to lymph node metastasis(RT=0.379, RN=0.213, P <0.001);(2) Overall survival in maximum tumor diameter ≥3 cm was signifi cantly shorter than that in <3 cm(P <0.001). Multivariate analysis showed that maximum tumor diameter, gender, age at diagnosis, extent of invasion, lymph node metastasis, gross type, degree of differentiation, tumor location were independent factors affecting survival(P <0.05).Conclusion Tumor length was an independent prognostic factor for survival time of ESCC patients.

关 键 词：食管癌 肿瘤最长径 T分期 生存期 

分 类 号：R735.1[医药卫生—肿瘤]