吸烟对中晚期食管癌患者放化疗后相关并发症和相关指标及预后的影响
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摘要
目的:探讨吸烟对中晚期食管癌患者放化疗后相关并发症和相关指标及预后的影响。方法:选取我院收治的60例中晚期食管鳞癌患者,根据患者既往是否存在吸烟史分为研究组(有吸烟史)与对照组(无吸烟史),每组30例,比较两组患者的并发症等。结果:两组患者放射性肺炎发生情况比较有统计学差异(P<0.05),而两组放射性食管炎及骨髓抑制发生情况比较无统计学差异(P>0.05);治疗前后,两组患者的血清及及病理相关分子的表达情况比较均有差异,且研究组显著高于对照组(P<0.05);血清VEGF、血清p53及Ki-67表达情况均与研究组患者治疗前的吸烟指数存在高度正相关(r=0.772、0.736、0.694,P均<0.05);随访1年,两组患者的1年局部控制率及1年总生存率比较无统计学差异(P>0.05)。结论:吸烟在食管癌的发生及发展中起着非常重要的作用,其是中晚期食管癌患者放化疗治疗的一个重要的危险因素,因此,在临床中应对吸烟的食管癌患者倍加关注。
Objective: To investigate the influence of smoking on the complications and related Indexes and prognosis of patients with advanced esophageal cancer after radiotherapy and chemotherapy. Methods: Sixty patients with advanced esophageal cancer after radiotherapy and chemotherapy were divided into study group who did smoke and control group who didn't smoke, 30 cases in each, then the two groups were compared in terms of complication and so on. Results: The incidence of the radiation pneumonitis in the study group as higher than that in the control group(P<0.05),and there were no significant differences in other complications(P>0.05). There were significant differences in the serum and pathology indexes between the two groups(P<0.05). there was a significant positive correlation between VEGF, p53, Ki-67 and smoking indexes(r=0.772, 0.736, 0.694, P<0.05).There were no significant differences in the 1-year OS and 1-year local control rate between the two groups(P>0.05). Conclusion: Smoking plays an important role in the occurrence and development of esophageal cancer, which is worthy of clinical attention.
Objective: To investigate the influence of smoking on the complications and related Indexes and prognosis of patients with advanced esophageal cancer after radiotherapy and chemotherapy. Methods: Sixty patients with advanced esophageal cancer after radiotherapy and chemotherapy were divided into study group who did smoke and control group who didn't smoke, 30 cases in each, then the two groups were compared in terms of complication and so on. Results: The incidence of the radiation pneumonitis in the study group as higher than that in the control group(P<0.05),and there were no significant differences in other complications(P>0.05). There were significant differences in the serum and pathology indexes between the two groups(P<0.05). there was a significant positive correlation between VEGF, p53, Ki-67 and smoking indexes(r=0.772, 0.736, 0.694, P<0.05).There were no significant differences in the 1-year OS and 1-year local control rate between the two groups(P>0.05). Conclusion: Smoking plays an important role in the occurrence and development of esophageal cancer, which is worthy of clinical attention.
引文
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[15] NAKAJO M,JINGUJI M,NAKABEPPU Y,et al.Texture analysis of 18F- FDG PET/CT to predict tumour response and prognosis of patients with esophageal cancer treated by chemoradiotherapy[J].Eur J Nucl Med Mol Imaging,2017,44(2):206- 214.
[2] ALLDINGER I,SISIC L,HOCHREITER M,et al.Outcome,complications,and mortality of an intrathoracic anastomosis in esophageal cancer in patients without a preoperative selection with a risk score[J].Langenbecks Arch Surg,2015,400(1):9- 18.
[3] OIKAWA M,HANADA M,HIDAKA S,et al.Current status of perioperative rehabilitation in patients who undergo esophagectomy for cancer[J].Kyobu Geka,2016,69(1):59- 64.
[4] TABUCHI T,GOTO A,ITO Y,et al.Smoking at the time of diagnosis and mortality in cancer patients:what benefit does the quitter gain[J].Int J Cancer,2017,140(8):1789- 1795.
[5] HERMAN A M,ORTIZ- GUZMANUZMAN J,KOCHUKOV M,et al.A cholinergic basal forebrain feeding circuit modulates appetite suppression[J].Nature,2016,538(7624):253- 256.
[6] HUMPHREY G,ROSSEN F,WALKER N,et al.Parental smoking during pregnancy:findings from the Growing Up in New Zealand cohort[J].N Z Med J,2016,129(1442):60- 74.
[7] MAI R Q,HUANG B,SHEN L,et al.Genotype distribution of human papillomavirus in women with abnormal cervical cytology in an esophageal carcinoma high incidence area of China[J].Asian Pac J Cancer Prev,2014,15(12):4945- 4950.
[8] ZH ANG L,SUN J,ZHANG J Q,et al.Expression and significance of molecular biomarkers in esophageal carcinoma in different nationalities patients in Xinjiang[J].Genet Mol Res,2014,13(3):5413- 5425.
[9] 曹彦坤,李润霄,田志辉,等.食管鳞癌单纯放化疗预后及相关因素分析[J].中华肿瘤防治杂志,2015,22(16):1297- 1302.
[10] CHAO Y K,CHUANG W Y,CHANG H K,et al.Prognosis of patients with esophageal squamous cell carcinoma who achieve major histopathological response after neoadjuvant chemoradiotherapy[J].Eur J Surg Oncol,2017,43(1):234- 239.
[11] HORI M,SOMEYA M,MATSUMOTO Y,et al.Influence of XRCC4 expression in esophageal cancer cells on the response to radiotherapy[J].Med Mol Morphol,2017,50(1):25- 33.
[12] 孙小莉,曹晓侠.伴有长期吸烟史食管癌患者中VEGF 和Ki- 67水平的临床意义[J].实用癌症杂志,2015,12(30):1793- 1795.
[13] 杨海平,吴骏,刘俊峰,等.食管癌患者手术前后血清p53抗体动态变化的临床研究[J].中华实验外科杂志,2015,4(32):890- 892.
[14] 杨莉,唐友明.非手术治疗老年食管癌患者的临床疗效分析[J].重庆医学,2013,42(27):3333- 3335.
[15] NAKAJO M,JINGUJI M,NAKABEPPU Y,et al.Texture analysis of 18F- FDG PET/CT to predict tumour response and prognosis of patients with esophageal cancer treated by chemoradiotherapy[J].Eur J Nucl Med Mol Imaging,2017,44(2):206- 214.