相同病理分期食管癌患者预后影响因素分析

Prognostic factors for patients with same pathological staging of esophageal carcinoma

目的探讨相同病理分期ⅡA期食管癌手术患者预后影响因素,为预后评估提供参考。方法回顾性分析178例ⅡA期食管癌手术患者的临床资料,结合随访资料进行预后因素分析。观察指标包括患者性别、年龄、肿瘤长度、肿瘤部位、分化程度、浸润深度、肿瘤类型、吻合部位、手术方式、术后并发症和术后治疗。采用Kaplan-Meier法进行生存分析,组间比较采用Log rank法,以Cox比例风险模型进行多因素分析。结果总的1、3和5年生存率分别为84.83%、49.44%和37.64%。单因素分析表明,肿瘤长度、肿瘤部位和手术方式为ⅡA期食管癌手术患者预后影响因素。Cox回归分析显示,肿瘤长度和肿瘤部位是ⅡA期食管癌手术患者预后的独立影响因素。结论相同病理分期ⅡA期食管癌手术患者预后受肿瘤长度等多种因素的影响,临床上应综合评估。

【Objective】 To explore the factors influencing prognosis of patients with the same pathological staging ⅡA esophageal carcinoma after radical resection, and to provide reference for the evaluation of prognosis. 【Methods】 The data of 178 patients with stage ⅡA esophageal carcinoma after radical resection were retrospectively analyzed. Combined with the clinical follow-up data, the factors of prognosis were analyzed.Observation index included gender and age of patients, length of tumor, location of tumor, grade of differentiation, depth of invasion, lymph node metastasis, tumor type, site of anastomosis, patterns of operation, postoperative complications and treatment after radical resection. Kaplan-Meier method was used to analyze the survival. The difference between groups was compared with Log rank method. Cox model was used for multivariate analysis. 【Results】 The survival rate of one, three and five years was 84.83%, 49.44% and 37.64%,respectively. Univariate analysis indicated that the length of tumor, location of tumor and patterns of operation were the influencing factors of prognosis for patients with stage Ⅱ A esophageal carcinoma after radical resection（P 0.05）. Cox multivariate analysis indicated that length of tumor and location of tumor were isolat ed influencing factors of prognosis（P 0.05）. 【Conclusions】 Prognosis of patients with the same pathological staging ⅡA esophageal carcinoma is affected by many factors, such as length of tumor and so on.Therefore evaluation of prognosis should be comprehensive in clinic.