食管鳞癌患者预后因素分析  

Prognosis factor analysis of Esophageal squamous carcinoma postoperatively

作　　者：刘阳[1] 赵妍[2] 袁翎[3] 王宇明[1] 陆维权 

机构地区：[1]郑州大学公共卫生学院,河南郑州450001 [2]河南省肿瘤医院放射介入科,河南郑州450000 [3]河南省肿瘤医院放疗科,河南郑州450000 [4]河南省肿瘤研究院流行病与卫生统计室,河南郑州450000

出　　处：《中华肿瘤防治杂志》2016年第2期91-95,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家自然科学基金(30930038,81302292)

摘　　要：目的近年来食管鳞癌的预后虽然有所改善,但其结果仍不能令人满意。本研究回顾性分析手术根治切除的食管鳞癌患者的临床病理资料,以探讨影响患者术后生存的主要因素。方法收集2009-01-01-2013-12-31在河南省肿瘤医院行食管癌根治术的2 558例患者临床资料,应用寿命表法计算患者术后总的1、3和5年生存率,用KaplanMeier法计算患者累积生存率,并绘出生存曲线,组间比较用Log-Rank检验,多因素分析采用Cox模型分析。结果全组患者总的1、3和5年生存率分别为87%、63%和46%。单因素分析结果显示,年龄(χ2=16.28,P<0.05)、肿瘤部位(χ2=7.02,P<0.05)、肿瘤长度(χ2=56.24,P<0.001)、病理形态(χ2=27.62,P<0.001)、分化程度(χ2=8.88,P<0.05)、浸润程度(χ2=104.03,P<0.001)、切缘肿瘤细胞残留(χ2=6.45,P<0.05)、有无淋巴结转移(χ2=102.57,P<0.001)和TNM分期(χ2=170.84,P<0.001)为食管鳞癌患者术后生存时间的影响因素。多因素Cox分析显示,有无淋巴结转移(χ2=7.62,P<0.05)、TNM分期(χ2=4.93,P<0.05)、浸润程度(χ2=6.33,P<0.05)、年龄(χ2=9.89,P<0.05)和分化程度(χ2=4.38,P<0.05)为食管鳞癌患者预后的独立危险因素。结论影响食管鳞癌患者术后生存的因素有多种,因此临床医师应结合患者的具体情况,选择最恰当的治疗措施和方案,以提高患者生存质量,延长生存期,改善患者的预后。OBJECTIVE Although the prognosis of esophageal squamous cell carcinoma has improved in recent years,the result is still unsatisfactory.The objective of this study was to analyze the clinical pathological date retrospectively and find the influence factors of survival time of esophaged squamous patients.METHODS The clinical and pathological data of 2558 cases were collected from January 1,2009 to December 31,2013 in Henan Cancer Hospital for esophageal cancer operation.The survival rate was calculated using life table method and compared between groups by Log-Rank test,survival curve was drawn by using Kaplan-Meier method,Cox model was used for multiple factor analysis.RESULTS The 1,3,5year overall survival rates were 87%,63%,46%.Univariate analysis showed that the age（χ2=16.28,P〈0.05）,tumor location（χ2=7.02,P〈0.05）,tumor length（χ2=56.24,P〈0.001）,pathological morphology（χ2=27.62,P〈0.001）,degree of differentiation（χ2=8.88,P〈0.05）,degree of infiltration（χ2=104.03,P〈0.001）,the cut edge residual tumor cells（χ2=6.45,P〈0.05）,lymph node metastasis（χ2=102.57,P〈0.001）and TNM staging（χ2=170.84,P〈0.001）were the factors affecting the survival time and postoperative mortality in patients with esophageal squamous cell carcinomas.Cox Multiple factors analysis showed that lymph node metastasis（χ2=7.62,P〈0.05）,TNM staging（χ2=170.84,P〈0.001）,age（χ2=9.89,P〈0.05）and degree of differentiation（χ2=4.38,P〈0.05）were the influence factors of prognosis of esophagus squamous patients.CONCLUSIONS The factors influencing survival rate of patients with esophageal squamous cell carcinoma are variable,clinicians should select the appropriated treatment measures considering the condition of patients for improving the quality of life,prolonging survival time and improving the prognosis.

关 键 词：食管鳞癌 外科手术 预后因素 生存分析 

分 类 号：R735.1[医药卫生—肿瘤]