食管腺癌临床病理特征及影响预后的因素

Clinicopathologic features and the influence factors of prognosis for esophageal adenocarcinoma

目的:分析食管腺癌手术患者的临床病理特征及影响预后的因素。方法:对2004年1月-2011年1月我院收治的20例食管腺癌及同期手术的24例食管鳞癌患者临床资料行回顾性分析。Kaplan-Meier方法绘制各临床病理参数的生存曲线,并用Breslow检验比较各组生存率变异。Cox模型分析影响食管癌患者预后的因素。结果:食管腺癌与鳞癌肿瘤平均长度分别为(4.2±1.8)cm、(5.4±2.0)cm(P<0.05)。生存时间分别为(20.2±15.0)月、(33.7±24.2)月(P<0.05)。食管腺癌肿瘤长度≥5cm的患者有12人,全部未发生淋巴结转移;肿瘤长度<5cm的有8人,其中有6人发生淋巴结转移(P<0.05)。单因素分析食管腺癌肿瘤长度、T分期、N分期、G分期、TNM分期及是否有淋巴结转移对生存时间均有影响(P<0.05)。多因素分析44例食管癌患者,TNM分期及组织学类型是影响其预后的因素(P<0.05)。结论:与食管鳞癌相比,食管腺癌肿瘤平均长度短,生存时间短。食管腺癌有无淋巴结转移与肿瘤长度有关。病变长度、T分期、N分期、G分期、TNM分期及有无淋巴结转移对食管腺癌预后有影响。TNM分期及组织学类型是影响食管癌预后的因素。

Objective：To analyze the clinicopathologic features of patients with EAC in west China.Methods：A total of 20 cases of EAC with esophagectomy was analyzed retrospectively and compared with 24 cases of the same period resected ESCC.The survival curves of all the clinicopathologic parameters were constructed using the Kaplan Meier method,and survival rate were evaluated by using the Breslow.By using Cox model,to analyse the influence factors on prognosis of all patients.Results：The average length of tumor for EAC and ESCC were（4.2 ± 1.76） cm,（5.4 ±1.97） cm,respectively（P 0.05）.The survival time were（20.2 ±15.0） months,（33.7 ±24.2） months,respectively（P 0.05）.The lymph node metastasis was associated with tumor length in EAC,on which tumor length equal or greater than 5cm were more likely to happen lymph node metastasis than that of less than 5cm（P 0.05）.The tumor length,T stage,N stage,G stage,TNM clinical stage,and lymph node metastasis in EAC influenced the survival time（P 0.05）.The TNM stage and histologic types were the independent factors,which could influence the prognosis of 44 patients with EC（P 0.05）.Conclusion：Tumor length and survival time had statistical significance between EAC and ESCC.Tumor length and survival time of EAC was shorter than ESCC（P 0.05）.Patients of EAC with lymph node metastasis or not only associated with the tumor length.The tumor length,T stage,N stage,G stage,TNM clinical stage,and lymph node metastasis in EAC influenced the prognosis.The TNM stage and histologic types were the independent factors,which can influence the prognosis of 44 patients with EC.