河南省2010年至2015年食管腺癌、SiewertⅠ型食管胃交界部腺癌和Barrett食管的发病和预后  

Incidence and prognosis of esophageal adenocarcinoma, Siewert type Ⅰ adenocarcinoma of esophagogastricjunction and Barrett esophagus in Henan province from 2010 to 2015

作　　者：石晓丹[1] 张梦[1] 赵萍[1] 马望[2] 周琳[1] Shi Xiaodan Zhang Meng Zhao Ping Ma Wang Zhou Lin(Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Chin)

机构地区：[1]郑州大学第一附属医院消化科,450052 [2]郑州大学第一附属医院肿瘤科,450052

出　　处：《中华消化杂志》2017年第9期581-586,共6页Chinese Journal of Digestion

基　　金：国家自然科学基金（81001103、81472325）

摘　　要：目的探讨食管癌高发区河南省食管腺癌、Siewert Ⅰ型食管胃交界部腺癌（AEG）和Barrett食管的发病和预后情况。方法收集2010年1月至2015年1月的152例食管腺癌、70例Siewert Ⅰ型AEG和149例Barrett食管患者的病历资料，回顾性分析其临床病理特征和治疗方式。对食管腺癌和Siewert Ⅰ型AEG患者行电话随访，Barrett食管患者行电话和内镜随访，随访时间截至2016年1月1日，共12～72个月。采用卡方检验、t检验和单因素方差分析比较各病理特征的组间差异，线性回归方法分析检出率随时间的变化趋势，Kaplan-Meier法进行生存分析。 结果食管腺癌5年检出率分别为0.7‰、0.9‰、0.8‰、1.1‰、1.1‰，呈上升趋势（F＝10.714，P〈0.05）；食管腺癌/食管鳞状细胞癌的构成比逐年依次为2.9%、3.2%、3.1%、3.4%、3.8%，呈上升趋势（F＝17.647，P〈0.05）。食管腺癌患者1、3、5年总体生存率分别为57.7%、30.6%、15.3%。152例食管腺癌患者中，51例行手术治疗，101例未行手术治疗，患者的中位生存时间为14个月，手术组和非手术组的中位生存时间分别为60个月和10个月。按治疗方法分层的生存曲线提示，手术联合化学治疗组、单纯手术组、单纯（放射）化学治疗组、未行任何治疗组3年累积生存率分别为82.3%、50.0%、11.2%、0；手术联合化学治疗组分别与单纯手术组、单纯（放射）化学治疗组、未行任何治疗组3年累积生存率比较，差异均有统计学意义（χ2＝1.099、2.236、11.431，P均〈0.01）。Siewert Ⅰ型AEG 5年检出率分别为0.2‰、0.3‰、0.4‰、0.4‰、0.7‰，呈上升趋势（F＝19.105，P〈0.05）。Siewert Ⅰ型AEG患者1、3、5年总体生存率分别为59.8%、30.5%、15.3%。70例Siewert Ⅰ型AEG患者中，行手术治疗16例，未行手术治疗54例，患者的中位生存时间为16个月，手术组和非手术组的中位生存时间分别为50个月和1ObjectiveTo explore the incidence and prognosis of esophageal adenocarcinoma （EAC）, Siewert type Ⅰ adenocarcinoma of esophagogastric junction （AEG） and Barrett esophagus （BE） in Henan province, an area of high incidence of esophageal cancer. MethodsFrom January 2010 to January 2015, the clinical data of 152 patients with EAC, 70 patients with Siewert type Ⅰ AEG and 149 patients with BE were collected, and the clinicopathological features and treatment methods of all the patients were retrospectively analyzed.Patients with EAC and Siewert type Ⅰ AEG were followed up by telephone, while the patients with BE were followed up by telephone and endoscopy examination. The follow-up was ended in January 1st 2016 and the total follow-up period was 12 to 72 months.Chi square test, t test and one way analysis of variance were performed for comparison of pathological characteristics among groups; linear regression method was used to detect changing trends in the rates over time and Kaplan-Meier method was for survival analysis.ResultsThe annual detection rates in five years of EAC were 0.7‰, 0.9‰, 0.8‰, 1.1‰ and 1.1‰, respectively, suggesting an increasing trend （F=10.714, P〈0.05）. The proportion of EAC to esophageal squamous carcinoma （ESC） were 2.9%, 3.2%, 3.1%, 3.4% and 3.8%, respectively with an increasing trend （F=17.647, P〈0.05）. The one-, three- and five-year overall survival rates of EAC were 57.7%, 30.6% and 15.3%.Among 152 patients with EAC, 51 received operation and 101 patients did not.The median survival time was 14 months, and the median survival time of operation group and non-operation group was 60 months and 10 months, respectively. Survival curve layered by treatment methods indicated that the three-year survival rates of operation combined with chemotherapy group, operation group, radiotherapy or chemotherapy group and no-treatment group were 82.3%, 50.0%, 11.2% and 0. The three-year survival rates in operation combined with chemotherapy group, operation grou

关 键 词：食管腺癌 SiewertⅠ型食管胃交界部腺癌 BARRETT食管 检出率 生存率 预后 

分 类 号：R735.1[医药卫生—肿瘤]