初诊肝和(或)肺转移食管鳞癌患者的预后因素分析  

Prognostic factors of patients with initial diagnosis of esophageal squamous cell carcinoma with liver and/or lung metastasis

作　　者：李慧[1,2] 陈健[3] 罗会芹[2] 马典庆 陈文菊[3] 闫滢[2] 吴书胜[2] 牛佳郁 柯丽红[2] 胡小秀[2] 李慧敏[2] 徐惠君[2] 胡冰[3] 何义富[1,2,3] 

机构地区：[1]皖南医学院研究生学院,安徽芜湖241000 [2]安徽省肿瘤医院肿瘤内科,安徽合肥230001 [3]安徽医科大学附属省立医院肿瘤内科,安徽合肥230001

出　　处：《肿瘤》2016年第2期187-193,共7页Tumor

基　　金：国家自然科学基金资助项目(编号:81472329);安徽省自然科学基金资助项目(编号:1408085MH179)~~

摘　　要：目的 :探讨影响初诊即确诊发生肝和(或)肺转移食管鳞癌患者的预后因素。方法 :回顾性分析了2013年1月—2015年1月由安徽医科大学附属省立医院和安徽省肿瘤医院收治的56例初诊时已确诊发生肝和(或)肺转移的食管鳞癌患者的临床资料,应用Kaplan-Meier法计算总生存(overall survival,OS)时间,log-rank法对影响预后的因素进行单因素分析,COX回归模型对影响预后的因素进行多因素分析。结果 :全组患者中位生存时间为11.8个月。单因素分析结果显示,美国东部协作肿瘤组(Eastern Cooperative Oncology Group,ECOG)体能状况(performance status,PS)评分、脏器转移部位和治疗方法与OS有关(P值均<0.05),而性别、年龄、肿瘤的分化程度、病灶转移数目、有无远处淋巴结(锁骨上淋巴结和腹腔干淋巴结)转移以及癌胚抗原(carcinoembryonic antigen,CEA)的表达水平均与OS无关(P值均>0.05)。多因素分析结果显示,ECOG PS评分和脏器转移部位为影响OS的独立因素。结论 :对于初诊时已发生肝和(或)肺转移食管鳞癌患者中,ECOG PS评分和脏器转移部位是影响远期生存的独立预后因素。Objective： To investigate prognostic factors of patients with initial diagnosis of esophageal squamous cell carcinoma with liver and/or lung metastasis.Methods： To retrospectively analyze the clinical data from 56 patients with initial diagnosis of esophageal squamous cell carcinoma with liver and/or lung metastatsis in Anhui Provincial Hospital and AnhuiProvincial Cancer Hospital between January 2013 and January 2015. Overall survival（OS） was estimated using Kaplan-Meier method, and any significant differences between the subgroups noted by univariate analysis were compared using log-rank test. Multivariate analysis was performed using COX regression model.Results： The median survival time of 56 patients with initial diagnosis of esophageal squamous cell carcinoma with liver and/or lung metastatsis was 11.8 months. Univariate analysis showed that Eastern Cooperative Oncology Group（ECOG） performance status（PS） score, involved sites and treatment protocols were significantly correlated with OS（all P 0.05）. However, gender, age, differentiation, number of involved sites, lymph node metastasis（supraclavicular lymph nodes and celiac lymph nodes） and carcino-embryonic antigen（CEA） level were not significantly correlated with OS（all P 0.05）. Multivatiate analysis showed that ECOG PS score and involved sites were independent prognostic factors.Conclusion： ECOG PS score and involved sites of patients with initial diagnosis of esophageal squamous cell carcinomawith liver and/or lung metastatsis may be independent prognostic factors.

关 键 词：食管肿瘤 肿瘤转移 抗肿瘤联合化疗方案 预后 

分 类 号：R735.1[医药卫生—肿瘤]