食管癌的临床病理特征与预后影响因素分析  

Clinicopathological characteristics and prognostic factors analysis of patients with esopha-geal cancer

作　　者：吕会来[1] 徐延昭[1] 李振华[1] 黄超[1] 王明博[1] 苏鹏[1] 刘钊 田子强[1] Lyu Huilai;Xu Yanzhao;Li Zhenhua;Huang Chao;Wang Mingbo;Su Peng;Liu Zhao;Tian Ziqiang(Department of Thoracic Surgery,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第四医院胸外科,石家庄050011

出　　处：《中华消化外科杂志》2022年第10期1363-1369,共7页Chinese Journal of Digestive Surgery

基　　金：国家癌症中心肿瘤科研专项课题(NCC2017A24);河北省自然科学基金(H2022206443)。

摘　　要：目的:探讨食管癌的临床病理特征与预后影响因素。方法:采用回顾性病例对照研究方法。收集2017年1月1日至2020年12月31日河北医科大学第四医院收治的447例食管癌患者的临床病理资料;男312例,女135例;年龄为60(37~82)岁。观察指标:(1)临床病理特征。(2)治疗情况。(3)随访情况。(4)食管癌预后影响因素分析。采用电话或门诊方式进行随访,了解患者生存情况。随访时间截至2021年12月。总生存时间定义为从手术日到死亡或最后1次随访时间。对随访时间>2年的患者进行生存和预后分析。正态分布的计量资料以x±s表示,偏态分布的计量资料以M(范围)表示。计数资料以绝对数表示。采用Kaplan-Meier法绘制生存曲线并计算生存率,采用Log-Rank检验进行生存分析。单因素分析采用Log-Rank检验,多因素分析采用COX风险回归模型。结果:(1)临床病理特征。447例患者中,男性占69.80%(312/447),女性占30.20%(135/447);发病年龄为30~39岁、40~49岁、50~59岁、60~69岁、70~79岁、80~89岁分别为3、18、101、229、93、3例;病理学类型为鳞癌、小细胞癌、腺鳞癌、肉瘤样癌、腺癌、神经内分泌癌、未分化癌、腺样囊性癌分别为424、11、4、3、2、1、1、1例;肿瘤位置为胸颈段、胸上段、胸中段、胸下段分别为2、49、273、123例;病理学T(pT)分期为pT0期、pT1a期、pT1b期、pT2期、pT3期、pT4a期、pT4b期分别为6、24、74、59、192、80、12例;病理学N(pN)分期中日本食道学会(JES)分期为pN0期、pN1期、pN2期、pN3期、pN4期分别为207、63、142、28、7例,国际抗癌联盟(UICC)分期为pN0期、pN1期、pN2期、pN3期分别为207、128、76、36例;TNM分期中JES分期为0期、Ⅰ期、Ⅱ期、Ⅲ期、Ⅳa期分别为25、53、127、174、68例,UICC分期为0期、Ⅰa期、Ⅰb期、Ⅱa期、Ⅱb期、Ⅲa期、Ⅲb期、Ⅲc期分别为16、9、53、35、108、96、45、85例。(2)治疗情况。447例患者中,6Objective To investigate the clinicopathological characteristics and prognostic factors of patients with esophageal cancer.Methods The retrospective case-control study was conducted.The clinicopathological data of 447 patients with esophageal cancer who were admitted to the Fourth Hospital of Hebei Medical University from January 1,2017 to December 31,2020 were collected.There were 312 males and 135 females,aged 60(range,37‒82)years.Observation indica-tors:(1)clinicopathological characteristics;(2)treatment;(3)follow-up;(4)analysis of prognostic factors for esophageal cancer.Follow-up using telephone interview or outpatient examination was conducted to detect survival of patients up to December 2021.The total survival time was from the surgery date to death or the last follow-up.Patients with duration of follow-up more than 2 years were included for survival and prognostic analysis.Measurement data with normal distribution were represented as Mean±SD,and measurement data with skewed distribution were represented as M(range).Count data were represented as absolute numbers.Kaplan-Meier method was used to draw survival curves and calculate survival rates.Log-Rank test was used for survival analysis.Univariate analysis was conducted using the Log-rank test.Multivariate analysis was conducted using the COX hazard regression model.Results(1)Clinicopathological characteristics.Of the 447 patients,69.80%(312/447)were males and 30.20%(135/447)were females,and there were 3,18,101,229,93,3 cases aged 30‒39 years,40‒49 years,50‒59 years,60‒69 years,70‒79 years,80‒89 years,respectively.About the pathological type,there were 424 cases with squamous carcinoma,11 cases with small cell carcinoma,4 cases with adenosquamous carcinoma,3 cases with sarco-matoid carcinoma,2 cases with adenocarcinoma,1 case with neuroendocrine carcinoma,1 case with undifferentiated carcinoma,and 1 case with adenoid cystic carcinoma.There were 2 cases with tumor located at cervicothoracic segment,49 cases with tumor located at upper thora

关 键 词：食管肿瘤 鳞状细胞癌 食管切除术 治疗策略 新辅助治疗 

分 类 号：R735.1[医药卫生—肿瘤]