3028例早期食管癌临床症状分析  

Clinical symptom analysis of 3 028 patients with early esophageal cancer

作　　者：钟侃 宋昕[1] 胡景峰 王伟[1,2] 李欣然[1] 杨苗苗 徐瑞华[1] 魏梦霞 韩文莉 雷玲玲 赵学科 孟超龙[1] 胡守佳 程锟[1,2] 王盼盼 陈瑶[1] 李留玉 吉佳佳 杨媛啧 王立东 ZHONG Kan;SONG Xin;HU Jingfeng;WANG Wei;LI Xinran;YANG Miaomiao;XU Ruihua;WEI Mengxia;HAN Wenli;LEI Lingling;ZHAO Xueke;MENG Chaolong;HU Shoujia;CHENG Kun;WANG Panpan;CHEN Yao;LI Liuyu;JI Jiajia;YANG Yuanze;WANG Lidong(State Key Laboratory of Esophageal Cancer Prevention&Treatment and Henan Key Laboratory for Esophageal Cancer Research,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052,China;Department of Pathology and Pathophysiology,School Basic Medicine Science,Zhengzhou University,Zhengzhou 450001,China)

机构地区：[1]郑州大学第一附属医院河南省食管癌重点开放实验室、省部共建食管癌防治国家重点实验室,河南郑州450052 [2]郑州大学基础医学院病理学与病理生理学教研室,河南郑州450001

出　　处：《肿瘤基础与临床》2020年第5期387-390,共4页journal of basic and clinical oncology

基　　金：国家自然科学基金资助项目(U1301227)。

摘　　要：目的分析早期食管癌的临床症状特点,阐明症状对食管癌早期预警的价值,为食管癌高危人群界定提供依据,分析早期食管癌是否出现相关症状的影响因素,为临床工作提供参考。方法对来自郑州大学第一附属医院省部共建食管癌防治国家重点实验室50万例食管癌患者临床信息数据库中的3028例早期食管鳞癌患者的临床症状等信息进行整理分析,应用多因素Logistic回归分析方法分析其是否出现相关症状的影响因素。结果3028例早期食管鳞癌患者中,67.83%的患者症状为吞咽困难或疼痛,17.01%的患者通过体检或陪伴检查确诊。年龄≥60岁(OR=1.372,P=0.002)、吸烟史阳性(OR=1.367,P=0.002)、TNM分期0期(OR=1.867,P<0.001)是早期食管癌患者无食管癌相关症状的独立危险因素。结论早期食管癌患者缺乏特异性临床症状,特别是年龄≥60岁、TNM分期早、吸烟史阳性的患者;临床症状对食管癌高危人群界定及早期预警的价值有限,需要将其与分子标志物等其他预警因素相结合。Objective To analyze the characteristics of clinical symptoms of early esophageal cancer,to clarify the value of symptoms for early alarm of esophageal cancer,to provide basis for the definition of high risk population of esophageal cancer,and to analyze the influence factors for the occurrence of symptoms of early esophageal cancer,so as to provide the reference for clinical work.Methods The clinical symptoms of 3028 patients with early esophageal squamous cell carcinoma from State Key Laboratory of Esophageal Cancer Prevention&Treatment and Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital of Zhengzhou University were sorted out and analyzed,and the influence factors of the symptoms were analyzed by using multi-factor Logistic regression method.Results In this study,67.83%of the patients had dysphagia or pain when swallowing,and 17.01%of the patients were confirmed by physical examination or accompanying examination.Age≥60 years(OR=1.372,P=0.002),smoking(OR=1.367,P=0.002)and early TNM stage(OR=1.867,P<0.001)were the independent risk factors for the absence of related symptoms in patients with early esophageal cancer.Conclusion Patients with early esophageal cancer lack specific clinical symptoms,especially those with age≥60 years old,positive smoking history and early TNM stage.The value of clinical symptoms in defining high risk population of esophageal cancer and early alarm is limited,so it is necessary to combine them with other early alarm factors such as molecular biomarkers.

关 键 词：早期食管癌 临床症状 高危人群界定 早期预警 

分 类 号：R735.1[医药卫生—肿瘤]