食管鳞癌术后患者预后相关因素研究  

Prognostic Factors of Postoperative Patients with Esophageal Squamous Cell Cancer

作　　者：岳盼盼 王道存[2] 李慧芝 贾慧雨 安志强[2] 黄圣迪 曹利艳 YUE Pan-pan;WANG Dao-cun;LI Hui-zhi;JIA Hui-yu;AN Zhi-qiang;HUANG Sheng-di;CAO Li-yan(Xinxiang Medical University,Xinxiang,China,453000;Puyang People’s Hospital,Puyang,China,457000;Henan University,Kaifeng,China,475000)

机构地区：[1]新乡医学院,河南新乡453000 [2]濮阳市人民医院,河南濮阳457000 [3]河南大学,河南开封475000

出　　处：《食管疾病》2022年第2期105-110,共6页Journal of Esophageal Diseases

摘　　要：目的探讨食管鳞癌(ESCC)术后患者预后影响因素。方法收集2010年1月至2020年10月濮阳市人民医院手术治疗且临床及随访资料完整的食管鳞癌患者408例,采用Kaplan-Meier法对患者一般情况及临床病理等13个相关因素行单因素分析,筛选出与患者术后预后有关的因素纳入Cox回归模型多因素分析,得到患者预后的独立影响因素,以P<0.05为差异有统计学意义。结果408例患者平均生存时间为47个月,中位生存时间38个月,总体1、3和5 a生存率分别为85.0%、65.0%、57.7%。单因素分析显示60岁以下、肿瘤最长径3 cm以下、高分化、低分期淋巴结转移ESCC患者术后预后较好(P<0.05)。Cox回归模型多因素分析显示,以>5 cm组、高分化、N3期、≥60岁作为对比组,最大长径≤3 cm组:P=0.000,OR=0.293,95%CI=0.186~0.463;3~5 cm组:P=0.016,OR=0.620,95%CI=0.421~0.914;分化程度低分化组:P=0.001,OR=3.462,95%CI=1.706~7.023;淋巴结转移N0期:P=0.010,OR=0.506,95%CI=0.302~0.848;年龄<60岁:P=0.059,OR=0.666,95%CI=0.437~1.015。结论肿瘤最长直径、分化程度、淋巴结转移为ESCC患者术后的独立预后影响因素;年龄极有可能成为ESCC术后患者的独立预后影响因素。Objective To explore the factors influencing the prognosis of postoperative patients with esophageal squamous cell carcinoma.Methods 408 cases of esophageal squamous cell carcinoma underwent surgical treatment with complete clinicopathological and follow-up data in Puyang People’s Hospital from January 2010 to October 2020,were collected.The Kaplan Meier method was used to conduct univariate analysis on 13 related factors such as the general situation and clinical pathology of the patients.The factors related to the postoperative prognosis of the patients were selected and included in the multivariate analysis of Cox regression model.The independent influencing factors of the prognosis of the patients were obtained.The difference was statistically significant with P<0.05.Results The mean survival time and median survival time(MST)of 408 patients were 47 months and 38 months,and the overall 1-,3-and 5-year survival rates were 85.0%,65.0%and 57.7%,respectively.Univariate analysis showed that patients with esophageal squamous cell carcinoma under 60 years old,tumor longest diameter less than 3 cm,well differentiated and low-stage lymph node metastasis had a better prognosis(P<0.05);Multivariate analysis of Cox regression model showed that:taking tumor longest diameter>5 cm group,highly differentiated,N3 stage and under 60 years old as the control group,the maximum length diameter≤3 cm group:P=0.000,OR=0.293,95%CI=0.186~0.463;3~5 cm group:P=0.016,OR=0.620,95%CI=0.421~0.914;low differentiation group:P=0.001,OR=3.462,95%CI=1.706~7.023;N0 stage of lymph node metastasis:P=0.010,OR=0.506,95%CI=0.302~0.848;age<60 years:P=0.059,OR=0.666,95%CI=0.437~1.015.Conclusion The longest tumor diameter,degree of differentiation and lymph node metastasis could be independent prognostic factors of esophageal squamous cell carcinoma.Age is highly likely to be an independent prognostic factor for postoperative esophageal squamous cell carcinoma.

关 键 词：食管鳞癌 临床病理 影响因素 预后 

分 类 号：R735.1[医药卫生—肿瘤]