胸段食管鳞癌患者经Ivor Lewis手术治疗后预后生存状况分析  

Analysis of prognosis and survival status of patients with thoracic esophageal squamous cell carcinoma treated by Ivor Lewis operation

作　　者：沈晓玲[1] 刘高利[1] 张娟[1] 曾艳[2] SHEN Xiao-ling;LIU Gao-li;ZHANG Juan;ZENG Yan(East Hospital,Wuhan University Renmin Hospital,Wuhan 430060,China;Optical Valley,Wuhan University Renmin Hospital,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院东院,湖北武汉430060 [2]武汉大学人民医院光谷院区,湖北武汉430060

出　　处：《实用医院临床杂志》2023年第4期64-67,共4页Practical Journal of Clinical Medicine

基　　金：湖北省自然科学基金资助项目(编号:2018FFC012)。

摘　　要：目的分析Ivor Lewis手术治疗后胸段食管鳞癌患者的预后生存状况及其预后的影响因素。方法2015年3月至2018年6月我院行Ivor Lewis术的97例食管鳞癌患者,回顾性整理患者临床及随访资料,统计患者预后生存状况,分析影响预后生存的危险因素。结果30例复发转移患者术后2、4年累计生存率分别为46.67%、20.00%,67例无复发转移患者术后2、4年累计生存率分别为88.06%、76.12%,复发组2、4年累计生存率低于无复发组(P<0.05)。复发组与无复发组年龄、肿瘤位置、有无术前新辅助治疗、术后有无胃排空障碍、吻合口瘘及乳糜胸等比较,差异无统计学意义(P>0.05),性别、病理T分期、病理N分期、肿瘤分化程度及有无术后辅助治疗等比较,差异有统计学意义(P<0.05)。肿瘤浸润深度、淋巴结转移数量、肿瘤分化程度、术后辅助治疗及基础疾病种类为影响胸段鳞癌患者预后的独立危险因素(P<0.05)。结论Ivor Lewis手术治疗胸段食管鳞癌患者预后生存的影响因素较多,对合并危险因素者,临床需要提前采取合理预防手段,提高患者预后生存时间。Objective To analyze the prognosis and survival status of patients with thoracic esophageal squamous cell carcinoma after Ivor Lewis operation and the prognostic factors.Methods Ninety-seven patients with esophageal squamous cell carcinoma who underwent Ivor Lewis surgery in our hospital from March 2015 to June 2018 were selected.The clinical and follow-up data of the patients were retrospectively analyzed.The prognosis and survival status of the patients were statistically analyzed.The risk factors affecting prognosis and survival status were also analyzed.Results There were 30 patients with postoperative recurrence and metastasis.Their 2-year and 4-year cumulative survival rates were 4667%and 2000%,respectively.There were 67 patients without recurrence and metastasis after surgery.Their 2-year and 4-year cumulative survival rates were 8806%and 7612%,respectively.The 2-year and 4-year cumulative survival rate in the recurrence and metastasis group was lower than that in the non recurrence and me-tastasis group(P<0.05).There were no significant differences in age,tumor location,preoperative neoadjuvant therapy,postoperative gastric emptying disorder,anastomotic leakage and chylothorax between the two groups(P>005).However,there were significant differences in gender,pathological T stage,pathological N stage,tumor differentiation and postoperative adjuvant therapy between the two groups(P<0.05).The depth of tumor invasion,number of lymph node metastasis,degree of tumor differentiation,postoperative adjuvant therapy and type of underlying diseases were independent risk factors affecting the prognosis and survival states of the patients(P<0.05).Conclusions There are many related factors that affect the prognosis and survival of patients with thoracic esophageal squamous cell carcinoma treated by Ivor Lewis surgery.For patients with risk factors,reasonable preventive measures should be taken in advance to improve the prognosis and survival time of the patients.

关 键 词：胸段食管鳞癌 Ivor Lewis手术 预后生存 危险因素 

分 类 号：R735[医药卫生—肿瘤]