食管胃交界部腺癌肿瘤源性坏死的临床病理特征  

Clinicopathological Features of Tumor Necrosis in Esophagogastric Junction Adenocarcinoma

作　　者：徐瑞华 宋昕[1] 赵学科[1] 郭贵周 魏梦霞 李贝[1] 范宗民[1] 孙琳[1] 李爱丽[2] 王献增 鲍启德[4] 高社干[1,5] 周福有[6] 王立东[1] XU Rui-hua;SONG Xin;ZHAO Xu-ke;GUO Gui-zhou;WEI Meng-xia;LI Bei;FAN Zong-min;SUN Lin;LI Ai-li;WANG Xian-zeng;BAO Qi-de;GAO She-gan;ZHOU Fu-you;WANG Li-dong(State Key Laboratory of Esophageal Cancer Prevention&Treatment and Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital,Zhengzhou University,Zhengzhou,China,450052;Linzhou Tumor Hospital,Linzhou,China,456550;Linzhou People’s Hospital,Linzhou,China,456550;Anyang Regional Hospital,Anyang,China,455002;State Key Laboratory of Esophageal Cancer Prevention&Treatment,Henan Key Laboratory of Microbiome and Esophageal Cancer Prevention and Treatment,Henan Key Laboratory of Cancer Epigenetics,Cancer Hospital,The First Affiliated Hospital(College of Clinical Medicine)of Henan University of Science and Technology,Luoyang,China,471003;Anyang Cancer Hospital,Anyang,China,455001)

机构地区：[1]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,河南郑州450052 [2]林州市肿瘤医院,河南林州456550 [3]林州市人民医院,河南林州456550 [4]安阳地区医院,河南安阳455002 [5]河南科技大学临床医学院,河南科技大学第一附属医院,肿瘤医院,省部共建食管癌防治国家重点实验室,河南省微生态与食管癌防治重点实验室,河南省肿瘤表观遗传重点实验室,中国洛阳471003 [6]安阳市肿瘤医院,河南安阳455001

出　　处：《食管疾病》2022年第1期20-24,共5页Journal of Esophageal Diseases

基　　金：国家自然科学基金重点项目(U1804262);国家自然科学基金面上项目(81872032)。

摘　　要：目的分析食管胃交界部腺癌(AEG)肿瘤源性坏死的临床病理特征,为AEG肿瘤源性坏死的分子机制及靶向治疗研究提供理论基础。方法样本来源于省部共建食管癌防治国家重点实验室食管癌和食管胃交界腺癌大数据库,共纳入1406例发生肿瘤源性坏死的AEG患者的临床病理资料,主要包含患者的基本信息、病理及临床诊疗信息。采用SPSS 21.0进行统计分析,计量资料用(x-±s)表示,计数资料用百分数表示,采用Kaplan-Meier生存分析绘制生存曲线,α=0.05。结果1406例发生肿瘤源性坏死的AEG患者,年龄(61.9±8.9)岁,男女比4.2∶1;AEG组织病理亚型中,低分化腺癌发生肿瘤源性坏死占比最大(54.3%);浸润深度中T3、T4居多(分别是69.0%、21.8%);发生淋巴结转移的比例是未发生转移的2.4倍;病理分期中以Ⅲ期为主(68.4%);发生肿瘤源性坏死的AEG患者的中位生存时间是2.5 a(95%CI:2.3~2.6);5 a生存率是25.0%。结论AEG肿瘤源性坏死的发生以男性为主,多为晚期,预后差;肿瘤源性坏死很可能是AEG预后的危险因素。Objective To provide a theoretical basis for the study of the mechanism and targeted treatment of subsequent tumor necrosis in esophagealgastric junction adenocarcinoma(AEG),by expounding the clinicopathological features of tumor derived necrosis in AEG.Methods The samples are taken from the database of esophageal cancer and esophageal-gastric junction adenocarcinoma of the State Key Laboratory of Esophageal Cancer Prevention&Treatment.1406 cases of AEG patients with tumor necrosis,including basic information,pathology and clinical diagnosis and treatment information were selected.SPSS 21.0 was used for statistical analysis,the measurement data was expressed by(x-±s),the counting data was expressed by percentage,and Kaplan-Meier survival analysis was used to draw the survival curve,α=0.05.Results The average age of 1406 AEG patients with tumor necrosis was(61.9±8.9)years old,and the ratio of male to female was 4.2∶1.Among the histopathological subtypes of AEG,tumor-induced necrosis was the largest in poorly differentiated adenocarcinoma(54.3%).T3 and T4 were the most in the depth of infiltration(69.0%and 21.8%respectively);lymph node metastasis was 2.4 times higher than that without lymph node metastasis.StageⅢwas the main pathological stage(68.4%).The median survival time of AEG patients with tumor necrosis was 2.5 years(95%CI:2.3~2.6);5-year survival rate was 25.0%.Conclusion The incidence of tumor-induced necrosis in AEG is mainly male,mostly in advanced stage,with poor prognosis.Tumor-induced necrosis is probably a risk factor for the prognosis of AEG.

关 键 词：食管胃交界腺癌 肿瘤源性坏死 临床病理特征 

分 类 号：R735.1[医药卫生—肿瘤]