食管癌/贲门癌病变患者生命质量随访研究  

Quality of life among patients with esophageal/gastric cardia precancerous lesion or cancer: a one-year follow-up study

作　　者：赵志梅[1,2] 潘雄飞[2] 黄文治[2,3] 温莹[2] 陈凤[2,4] 黄荷[2,5] 兰慧[2,6] 徐明珏[1] 杨春霞[2] 

机构地区：[1]中国医学科学院(北京协和医学院)医学生物学研究所,云南昆明650118 [2]四川大学华西公共卫生学院(华西第四医院),四川成都610041 [3]四川大学华西医院,四川成都610041 [4]德阳市人民医院,四川德阳618000 [5]贵州省疾病预防控制中心,贵州贵阳550004 [6]锦江区疾病预防控制中心,四川成都610011

出　　处：《现代预防医学》2015年第24期4417-4420,共4页Modern Preventive Medicine

摘　　要：目的评价食管癌/贲门癌病变患者治疗前后生命质量变化情况。方法以河南林州经早诊早治项目筛查并经病理学确诊的食管癌/贲门癌癌前病变及以上患者为研究对象,运用EQ-5D量表,分别于治疗前、治疗后1、6、12个月进行生命质量评估。结果共纳入73例癌前病变患者,88例早期癌患者,58例中晚期癌患者。治疗前3组得分分别为(0.90±0.05)、(0.87±0.09)、(0.81±0.17)分,中晚期癌组得分最低(P<0.01)。治疗后1个月,癌前病变组得分明显降低[(0.85±0.09)分,P<0.01)],后逐渐恢复,12个月时超过治疗前[(0.91±0.03)分,P<0.05)]。早期癌组得分变化趋势与癌前病变组相似,但12个月时仍低于治疗前水平[分别为(0.85±0.15)分和(0.87±0.09)分,P=0.226)]。治疗后中晚期癌组得分持续下降,6个月时达最低[(0.74±0.28)分,P<0.05)],12个月时恢复到治疗前水平[(0.80±0.13)分,P=0.624)]。结论食管/贲门癌前病变和早期癌组生命质量始终高于中晚期癌组,提示食管/贲门癌早期识别与治疗有利于提高患者生命质量。Objective The aim of this study was to assess the health related quality of life（QOL） among patients with esophageal/gastric cardia precancerous lesion or cancer at different stages, and evaluate changes in QOL during the follow-up after primary treatment. Methods EQ-5D questionnaire was used to assess QOL of patients with esophageal/gastric cardia lesion in Linzhou of Henan province. Patients were surveyed before primary treatment and at one, six, and 12 months after primary treatment.Results Totally, 73 patients with precancerous lesion, 88 patients with early stage cancer and 58 patients with advanced cancer were recruited. Prior to primary clinical treatment, the average EQ-5D scores for the above three groups of patients were 0.90±0.05, 0.87±0.09, 0.81±0.17, respectively. The score of patients with advanced cancer was significantly lower than that of patients with early stage cancer or precancerous lesion（P〈0.01）. For the precancerous lesion, the score declined in the first month（0.85±0.09, P〈0.01）, and gradually increased to a higher level at 12 months than the score before the treatment（0.91±0.03, P〈0.05）.EQ-5D score followed a similar trend for early stage cancer, though it was not statistically recovered even at 12 months（0.85±0.15 vs 0.87±0.09, P=0.226）. Regarding advanced cancer, the results showed a consistent decline, reached the lowest at six months（0.74 ±0.28, P〈 0.05）, and finally rebounded to a similar level compared to that before treatment（0.80 ±0.13, P=0.624）.Conclusion Patients with precancerous lesion or early stage esophageal/gastric cardia cancer have better QOL than those with advanced cancer. Early detection and treatment improve QOL in the long run, despite QOL compromise in the immediate time.

关 键 词：食管癌 生命质量 EQ-5D 随访研究 

分 类 号：R181.32[医药卫生—流行病学]