T1期浸润性原发性食管癌的临床病理特征及预后  

Clinic features and prognostic analysis for T1 esophagus cancer

作　　者：于哲[1] 李晓敏[2] 槐梅 路桂杰 王冲 王全玉 刘庆熠[6] Yu Zhe;Li Xiaomin;Huai Mei;Lu Guifie;Wang Chong;Wang Quanyu;Liu Qingyi(Department of Cardio-Thoracic Surgery, the General Hospital of Huabei Petroleum Administration, Renqiu 062550, China;Department of Pathology, the General Hospital of Huabei Petroleum Administration, Renqiu 062550, China;Department of Clinical Laboratory, the General Hospital of Huabei Petroleum Administration, Renqiu 062550, China;Department of Imaging, the General Hospital of Huabei Petroleum Administration, Renqiu 062550, China;Department of lnterventional Radiology, the General Hospital of Huabei Petroleum Administration, Renqiu 062550, China;Department of Cardio-Thoracic Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, China)

机构地区：[1]华北石油管理局总医院心胸科,河北省任丘市062550 [2]华北石油管理局总医院病理科,河北省任丘市062550 [3]华北石油管理局总医院检验科,河北省任丘市062550 [4]华北石油管理局总医院影像科,河北省任丘市062550 [5]华北石油管理局总医院介入科,河北省任丘市062550 [6]河北医科大学第四医院胸心外科,石家庄050000

出　　处：《中华肿瘤杂志》2018年第4期268-273,共6页Chinese Journal of Oncology

摘　　要：目的探讨T1期原发性食管癌的临床病理特征及其与患者预后的关系。方法收集2001年1月至2009年12月间就诊于河北医科大学第四医院、经手术治疗且病理确诊的212例T1期原发性食管癌患者的临床资料，其中男148例，女64例；pTla期患者91例，pTlb期患者121例。分析患者的临床病理特征和预后。结果212例患者的生存时间为27-108个月，中位生存时间为80．8个月。Tla期患者的1、3、5年生存率分别为100％、97．8％和94．5％，中位生存时间为86．8个月。Tlb期患者的1、3、5年生存率分别为100％、95．9％和74．4％，中位生存时间为76．2个月。121例Tlb期患者的淋巴结转移率为26．4％（32／121），其中sml期、sm2期和sm3期患者的淋巴结转移率为11．6％（3／26）、15．O％（6／40）和41．8％（23／55）；sml期与sm2期患者的淋巴结转移率差异无统计学意义（P=0．973），sm3期患者的淋巴结转移率均高于sml期和sm2期患者（均P〈O．05）。结论Tla期食管癌患者行内镜下病变切除术是可行的。建议对Tlb食管癌患者行食管癌根治性切除术和周围淋巴结清扫术，术后辅助化疗可使Tlb期，尤其是伴有周围淋巴结转移的食管癌患者术后生存获益。Objective To investigate relationship between the clinicopathological features and prognosis of T1 esophageal carcinoma. Methods Data from 212 T1 primary esophageal cancer patients, who underwent radical surgery in The Fourth Hospital of Hebei Medical University from Jan 2001 to Dec 2009 were enrolled. There were 148 males and 64 females. There were 91 patients with stage pTla and 121 patients with stage pTlb. Results The survival of the 212 patients was 27-108 months, and the median survival was 80.8 months. The 1, 3, and 5 year survival rates of patients with stage Tla were 100%, 97.8% and 94.5%, respectively, and the median survival was 86.8 months. The 1, 3, and 5 year survival rates of patients with stage Tlb were 100%, 95.9% and 74.4%, respectively, and the median survival was 76.2 months. The rate of lymph node metastasis in 121 patients with stage Tlb was 26.4% （32/121）. The lymph node metastasis rates in patients with stage sml, sin2 and sin3 were 11.6% （3/26） , 15.0% （6/40） and 41.8% （23/55） , respectively. There was no significant difference in lymph node metastasis between stage sml patients and stage sm2 patients （P= 0.973）. Lymph node metastasis rates in patients with stage sm3 were higher than those in stage sml and sin2 （P〈 0.05 ）. Conclusion Radical resection of esophageal carcinoma with peripheral lymph node dissection is recommended for patients with Tlb esophageal carcinoma.

关 键 词：食管肿瘤 病理学 临床 淋巴结转移 预后 放化疗 辅助 

分 类 号：R735.1[医药卫生—肿瘤]