影响食管癌手术治疗患者预后的病理因素分析  

The Cancerous Factors Influencing the Prognosis of the Patients with esophagectomy

作　　者：王永岗[1] 汪良骏[1] 张庆斌[2] 刘向阳[1] 张汝刚[1] 张大为[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院胸外科,100021 [2]贵州省人民医院胸心外科,550002

出　　处：《实用癌症杂志》2001年第5期516-517,520,共3页The Practical Journal of Cancer

摘　　要：目的　分析影响食管癌手术治疗患者预后的病理因素。方法　对 2 43例单纯手术治疗的食管鳞癌患者的临床资料进行回顾性分析。结果　T1、T2 、T3 患者的 5年生存率分别为 75 .0 % ,48.6 %和 39.7% ,明显高于T4 患者的 5年生存率 ( 18.2 % ) ;有淋巴结转移者的 5年生存率为 16 .4% ,明显低于无淋巴结转移者 ( 5 1.9% )P <0 .0 1) ;低分化肿瘤患者的 5年生存率为 16 .2 % ,明显低于高分化肿瘤患者 ( 5 0 .0 % )P <0 .0 1;Ⅱb期患者的 5年生存率和Ⅲ期患者相近 ,但明显低于Ⅲa期患者 ;肿瘤长度和淋巴结转移个数与预后的关系不大。结论　影响食管癌手术治疗患者预后的因素有肿瘤外侵、淋巴结转移、肿瘤分化的TNM分期。淋巴结转移是影响患者预后的主要因素 。Objective To study cancerous factors which influence the prognosis of the patients with esophagectomy.Methods The clinical material of 243 patients who underwent resection of squamous cell carcinoma of esophagus was analyzed retrospectively.Results The 5 years survival rates of the patients with T 1?T 2 and T 3?were 75.0%,48.6% and 39.7% respectively,higher than the 18.2% of the patients with T 4.The 5 years survival rate of the patients with lymph node metastases was 16.4%,much lower thah the51.9% of the patients without lymph node metastasis ( P <0.01).The 5 years survival rate of the patients with low differentiation tumor was 16.2%,much lower than the 50.0% of the patient with high differentiation tumor.Tumor length and the numbers of lymph node metastases had little influence on the patients′ prognosis .The 5 years survival rate of the patients with stage Ⅱb was 23.5%,similar to that of the patients with stage Ⅲ but lower than that of the patients with stage Ⅱa.Conclusion The factors of cancer that influence the prognosis of the patients with esophagectomy were tumor extrainvasion,lymph node metastasis,tumor differentiation and TNM staging.Because lymph node metastasis is the chief one among them,the reasonable and effective lymph node dissection is the key method to improve the patients′ prognosis.

关 键 词：食管癌 外科治疗 预后 病理因素分析 外科手术 

分 类 号：R735.1[医药卫生—肿瘤] R730.56[医药卫生—临床医学]