女性食管癌的临床病理特点及生存分析

Clinicopathological characteristics and survival analysis of female patients with esophageal carcinoma

目的探讨女性食管癌患者的临床病理特征及生存预后。方法回顾性分析2008年1月至2011年12月在我院住院且经手术病理证实为食管癌的261例女性患者的临床病理资料及生存时间,并与同期的797例男性食管癌患者进行比较。采用单因素和多因素方法分析影响女性食管癌患者预后的因素。结果女性食管癌患者的中位发病年龄为63岁,病变位置中颈段及胸上段比例为16.9%,病变长度<5cm比例为90.0%,浸润深度为pT1～pT2比例为49.8%,病理TNM分期为Ⅰ、Ⅱ期比例为74.7%,淋巴结转移率为30.6%,脉管癌栓率为9.2%。与男性相比较,女性食管癌患者的发病年龄较晚,病变部位较高,病变长度较短,病变浸润深度较浅,病理TNM分期较早,淋巴结转移率及脉管侵犯率较低;而在病理类型、神经侵犯率、组织分化方面与男性患者的差异无统计学意义(P>0.05)。女性患者术后1、2、3年生存率分别为89.3%、74.0%和66.7%,而男性患者分别为86.5%、65.8%和51.3%,差异有统计学意义(P=0.015)。肿瘤长度、浸润深度、淋巴结转移、病理TNM分期是女性食管癌患者的独立预后因素。结论女性食管癌在发病年龄、病变部位、病变长度、浸润深度、淋巴结转移、病理TNM分期、脉管癌栓等方面具有与男性食管癌不同的临床病理特点。女性食管癌患者的预后要优于男性,可能与其病变长度较短、浸润深度较浅、淋巴结转移率较低及病理TNM分期较早等因素有关。

Objective To investigate the clinicopathological characteristics and survival of female patients with esophageal carcinoma. Methods The clinicopathological characteristics and survival time of 261 female patients with esophageal carcinoma, con- firmed by surgical pathology specimens in our hospital from January 2008 to December 2010, were retrospectively analyzed, and were compared to 797 male patients with esophageal carcinoma under the same conditions. Univariate and multivariate methods were used to analyze the prognostic factors of female patients. Results The median onset age of female patients with esophageal cancer was 63. Pa- tients with the lesion site in neck or upper thorax accounted for 16. 7%0 in female. There were 90. 8% of female patients with tumor size less than 5era. The depth invasion of pTj-pT2 accounted for 49. 8% in female. The pathological TNM stage of I or ]] in female ac- counted for 74. 7%. The lymphatic metastasis rate and vessel invasion rate in female patients accounted for 30. 60/0 and 9.2%0 , respec- tively. Compared with male patient, female patients with esophageal cancer had older average onset age, higher lesion site, shorter tumor size,more superficial depth invasion,earlier pathological TNM stage,less lymphatic metastasis rate and vessel invasion rate. No significant sex-related differences were found in gross morphology, pathological type, neural invasion rate, tumor size and differentiation （P 〉0. 05）. The 1-, 2-and 3-year survival rates were 89. 30/0 , 74.00/0 and 66. 7% in female compared with 86. 5% , 65.8% and 51.3% in male （ P = 0. 015 ）. Length of tumor, tumor invasion depth, lymphatic metastasis rate and pathological TNM stage were inde- pendent prognostic factors in female. Conclusion Female patients with esophageal cancer were different from male patients in the on- set age, lesion site, lesion length, depth of invasion, lymph node metastasis, TNM stage and vessel invasion. The prognosis of the fe- male patients with esophageal carcinoma is better than male patients, which is influenced by the short lesion length, shallow invasion depth, low lymphatic metastasis rate and early pathological TNM stage.