血小板与性别的交互作用对食管鳞癌根治术患者预后的影响  

A study on the interaction effect of platelet count and sex on prognosis in patients with esophageal squamous cell carcinoma after esophagectomy

作　　者：俞凯莉 林征 邱模良[2] 刘双 谢倩雯 饶雯清 陈元美[3] 林剑波[4] 胡志坚 YU Kai-li;LIN Zheng;QIU Mo-liang;LIU Shuang;XIE Qian-wen;RAO Wen-qing;CHEN Yuan-mei;LIN Jian-bo;HU Zhi-jian(Department of Epidemiology and Health Statistics,School of Public Health,Fujian Medical University,Fuzhou 350122,China;Department of Radiology,The First Hospital of Fuzhou,Fuzhou 350009,China;Department of Thoracic Surger,Fujian Cancer Hospital,Fuzhou 350014,China;Department of Thoracic Surger,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350004,China)

机构地区：[1]福建医科大学公共卫生学院流行病与卫生统计学系,福州350122 [2]福州市第一医院影像科,福州350009 [3]福建省肿瘤医院胸外科,福州350014 [4]福建医科大学附属第一医院胸外科,福州350004

出　　处：《中华疾病控制杂志》2022年第7期820-826,共7页Chinese Journal of Disease Control & Prevention

基　　金：国家重点研发计划(2017YFC0907100);福建省医学创新课题(2018-CX-38)。

摘　　要：目的探讨血小板(platelets,PLT)对食管鳞癌(esophageal squamous cell carcinoma,ESCC)根治术患者预后的影响及其与性别、年龄间的交互作用。方法选取2014年2月1日―2018年11月30日582例符合入组标准的ESCC患者进行回顾性分析。Kaplan-Meier法用于绘制生存曲线并行log-rank检验。运用Cox比例风险回归模型进行多因素分析,计算总生存时间(overall survival,OS)、无病生存时间(disease free survival,DFS)的危险系数(hazard ratios,HR)及其95%CI。结果PLT仅与性别存在交互作用(HR=2.417,95%CI:1.150~5.078,P=0.018)。分层分析显示,男性PLT增多组的死亡风险是PLT正常组的1.713倍(HR=1.713,95%CI:1.203~2.441,P=0.003);女性PLT增多组与PLT正常组预后差异无统计学意义(HR=0.590,95%CI:0.299~1.165,P=0.129)。结论PLT与性别对ESCC根治术患者预后的预测存在交互作用,采用PLT预测患者预后时应注意性别的差异。Objective To investigate the prognostic value of the preoperative platelet count(PLT)and its interactions with gender and age in patients with esophageal squamous cell carcinoma(ESCC)after esophagectomy.Methods A total of 582 patients with ESCC were eligible for retrospective analysis between February 1,2014,and November 30,2018.The survival rate was calculated using the Kaplan-Meier method and the comparison of the two groups was performed by using the Log-rank test.Univariate and multivariate analyses were calculated using the Cox proportional hazards regression model to determine prognostic factors associated with overall survival(OS)and disease-free survival(DFS).Hazard ratios(HRs)and(95%CI)were used as common measures to assess relative risk.Results PLT only interacted with gender(HR=2.417,95%CI:1.150-5.078,P=0.018).Stratified analysis showed that PLT increased group was independently associated with a 71.3%risk increase for death com-pared with PLT normal group(HR=1.713,95%CI:1.203-2.441,P=0.003)in male patients;While in female patients,there was no statistical significance between groups(HR=0.590,95%CI:0.299-1.165,P=0.129).Conclusions There is an interaction between PLT and gender in predicting the prognosis of patients with ESCC after esophagectomy.Gender differences should be paid attention to when PLT is chosen to be a prognostic factor.

关 键 词：食管鳞癌 血小板 预后 性别 交互作用 

分 类 号：R735.1[医药卫生—肿瘤]