胸段食管鳞癌根治性术后复发转移风险预测模型的初步分析  

Preliminary analysis of risk prediction model for recurrence and metastasis of thoracic esophageal squamous cell carcinoma after radical surgery

作　　者：武亚娟[1] 李晓敏[1] 李琦[1] 任雅琼[1] Wu Yajuan;Li Xiaomin;Li Qi;Ren Yaqiong(Department of Radiation Oncology ,Shanxi Provincial Cancer Hospital,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院放疗胸部二病区,太原030013

出　　处：《中国医师杂志》2019年第1期98-102,共5页Journal of Chinese Physician

摘　　要：目的构建一个胸段食管鳞癌根治术后复发转移的风险预测模型,并进行无病生存期(DFS)的影响因素分析。方法对2007年1月至2011年12月共1 191例接受了根治性手术切除的胸段食管鳞癌患者进行回顾性分析,风险预测模型VaR界值经ROC曲线取得,并对界值进行验证;对影响患者DFS的因素进行单因素预后分析和Cox多因素预后分析。结果全组共有472例患者出现治疗后复发转移。治疗后复发转移患者VaR值与无复发转移患者相比差异有统计学意义(t=-5. 307,P <0. 001)。ROC曲线分析结果显示VaR界值为0. 30,VaR <0. 30组患者复发转移率为27. 5%,显著低于≥0. 30组的48. 2%(χ2=51. 659,P <0. 001)。单因素分析显示患者性别、病变长度、组织分化程度和VaR值均为影响患者复发转移的因素(χ2=13. 460,21. 111,17. 540,39. 175,P均<0. 001)。多因素分析结果显示患者组织分化程度和VaR值为影响患者复发转移的独立性因素(P均<0. 001)。结论该模型可用于胸段食管鳞癌根治性术后患者复发转移风险的预测。Objective The aim of this study is to build a risk prediction model for the recurrence and metastasis of thoracic esophageal squamous cell carcinoma after radical surgery,and to analyze the factors affecting the disease free survival (DFS).Methods Conducted analysis of 1 191 patients with thoracic esophageal squamous cell carcinoma,who received radical resection from January 2007 to December 2011.The VaR boundary value of the risk prediction model was obtained by receiver operating characteristic (ROC)curve,and the boundary value was verified.The factors that affected DFS were analyzed by univariate analysis and Cox multiple factor prognosis analysis.Results There were 472 cases had recurrence and metastasis after treatment.There was a significant difference in VaR between patients with and without failure (t =-5.307,P <0.001).The VaR boundary value was 0.30 according to ROC curve analysis.The recurrence rate of the patients in the VaR <0.30 group was 27.5%,which was significantly lower than 48.2%in the ≥0.30 groups (x^2 =51.659,P <0.001 ).The univariate analysis showed that the patient's sex,the length of the lesion,the degree of tissue differentiation and the VaR value were all factors that significantly affected the recurrence and metastasis of the patients (x^2 =13.460,21.111,17.540,39.175, P <0.001 ).Multivariate analysis showed that tissue differentiation and VaR were independent factors affecting recurrence and metastasis of patients (P <0.001 ).Conclusions The model can be applied to predict the recurrence and metastasis risk of patients with thoracic esophageal squamous cell carcinoma after radical surgery.

关 键 词：食管肿瘤 肿瘤 鳞状细胞 食管切除术 肿瘤复发 局部 肿瘤转移 危险因素 

分 类 号：R735.1[医药卫生—肿瘤]