摘要
目的:探讨胸段食管鳞癌患者根治切除术后预后的影响因素。方法:收集381例接受根治切除术治疗的胸段食管鳞癌患者的临床、病理与随访资料,采用Kaplan-Meier法进行生存分析,应用Cox回归模型筛选术后预后影响因素。结果:381例患者术后1、2、3 a生存率分别为87. 9%、72. 2%、68. 2%。Cox回归分析结果显示,N分期是胸段食管鳞癌根治切除术后预后的独立危险因素,N1、N2、N3期相较N0期的HR(95%CI)分别为2. 528(1. 345~4. 751)、4. 122(1. 571~10. 815)和8. 387(2. 356~29. 860)。结论:N分期是胸段食管鳞癌根治切除术后预后的独立危险因素。
Aim: To discuss the influencing factors of prognosis of patients with thoracic esophageal squamous cell carcinoma after radical resection. Methods: Clinicopathological and follow-up data of 381 patients with thoracic esophageal squamous cell carcinoma who underwent radical resection were collected. Kaplan-Meier survival analysis was conducted,and the influencing factors of prognosis were analyzed using Cox regression model. Results: The overall 1-,2-,3-year survival rates were 87. 9%,72. 2%,68. 2%,respectively. Cox analysis showed that N stage was the independent risk factor for the postoperation prognosis( P < 0. 05),the HR( 95% CI) of N1,N2 and N3 stage compared with N0 stage was 2. 528( 1. 345-4. 751),4. 122( 1. 571-10. 815) and 8. 387( 2. 356-29. 860),respectively. Conclusion: N stage is the independent risk factor for the patients with thoracic esophageal squamous cell carcinoma after radical resection.
引文
[1] SIEGEL RL,MILLER KD,JEMAL A,et al. Cancer statistics[J]. JAMA,2013,310(9):982
[2] HENRY MA,LERCO MM,RIBEIRO PW,et al. Epidemiological features of esophageal cancer:squamous cell carcinoma versus adenocarcinoma[J]. Acta Cir Bras,2014,29(6):389
[3] TORRE LA,BRAY F,SIEGEL RL,et al. Global cancer statistics,2012[J]. CA Cancer J Clin,2015,65(2):87
[4] CHEN W,ZHENG R,BAADE PD,et al. Cancer statistics in China,2015[J]. CA Cancer J Clin,2016,66(2):115
[5]乔友林.食管癌流行病学研究的重要里程碑[J].中国肿瘤临床,2016,43(12):500
[6]吴想军,李子巍,屈若祎,等. 2004-2010年中国消化道恶性肿瘤死亡率趋势分析[J].中国卫生统计,2017,34(1):43
[7]祝淑钗,宋长亮,沈文斌,等.食管癌根治性切除术后患者预后的影响因素分析[J].中华肿瘤杂志,2012,34(4):281
[8]黄志刚,范增林,李学民,等. 971例食管癌切除术后患者预后的Cox回归分析[J].实用肿瘤杂志,2005,20(3):263
[9]郑伟慧,杨迅,周鑫明,等.大宗胸段食管鳞癌根治术后的生存分析及模型预测[J].中华胸心血管外科杂志,2017,33(5):290
[10]张洪典,尚晓滨,朱晓雷,等.淋巴结清扫数目对食管鳞癌患者预后的影响分析[J].中华消化外科杂志,2018,17(8):817
[11]刘艳虎,薛栋,李娟,等. p T2-3N0-1M0期胸段食管鳞癌根治术患者的预后分析[J].临床肿瘤学杂志,2017,22(11):1006
[12]肖泽芬,杨宗贻,王绿化,等.食管癌术后淋巴结转移对生存率的影响和放射治疗的意义[J].中华肿瘤杂志,2004,26(2):112
[13]宋春洋,李腾,赵彦,等.ⅡB-Ⅲ期食管癌根治术后预防性放疗疗效分析[J].肿瘤防治研究,2018,45(6):404
[14]沈文斌,高红梅,祝淑钗,等.Ⅱ和Ⅲ期胸段食管鳞癌术后不同辅助治疗方式治疗后的失败模式分析[J].肿瘤防治研究,2017,44(5):340
[15]宋振焱,焦言,李洪升,等.食管鳞癌根治术后失败模式分析[J].中华肿瘤防治杂志,2018,25(2):126
[16]邓文英,魏辰,李宁,等.食管癌根治术后患者淋巴结转移与预后的关系[J].中华医学杂志,2016,96(47):3829
[17]CHEN J,ZHU J,PAN J,et al. Postoperative radiotherapy improved survival of poor prognostic squamous cell carcinoma esophagus[J]. Ann Thorac Surg,2010,90(2):435