食管神经内分泌癌41例临床特点及预后分析

Clinical Features and Prognosis of Neuroendocrine Carcinoma of Esophagus:41 Cases Analysis

目的 探讨食管神经内分泌癌的临床特征及预后影响因素。方法 回顾性分析2008年3月至2014年3月间江苏省南京医科大学第一附属医院胸外科收治的41例食管神经内分泌癌患者的临床资料,其中男37例、女4例,年龄40～79（61.1±7.9岁）岁。本组41例患者全部行手术切除,并行淋巴结清扫。结果 全部41例患者围手术期未发生严重并发症,住院期间无死亡。术后接受化疗＋放疗13例,单纯化疗11例,单纯放疗1例,剩余16例术后未做特殊治疗。患者随访6～61（24.0±13.6）个月,41例患者中22例存活,19例死亡。1、2、3、4、5年生存率分别为80.49%、39.02%、21.95%、7.32%、4.88%。接受单一手术治疗和术后综合治疗的中位生存时间分别为12.0个月和25.0个月,差异有统计学意义（P〈0.05）。T2～T4期和T1期的中位生存时间分别为20.0个月和37.5个月,差异有统计学意义（P〈0.05）。Cox回归分析显示,肿瘤浸润深度、术后辅助化放疗是影响患者预后的独立因素（P〈0.05）。结论 食管神经内分泌癌少见,恶性程度高,外科手术与术后综合治疗相结合有望提高其远期生存率。

Objective To explore the clinical features and the prognostic factors of nenroendocrine carcinoma of the esophagus. Methods We retrospectively analyzed clinical data of 41 cases of neuroendocrine carcinoma of the esophagus admitted in the First Affiliated Hospital of Nan）ing Medical University between March 2008 and March 2014. There were 37 males and 4 femaJes at a mean age of 61.1＋7.9 years （ranged from 40 to 79 years）. All patients underwent surgical resection and lymph node dissection. Results No severe complications occurred during the perioperative period, and no death occurred during the period of hospitalization.Thirteen patients received postoperative chemotherapy and radiotherapy. Eleven patients received simple postoperative chemotherapy. One patient received postoperative radiotherapy. The remaining 16 patients did not receive any special treatment. The patients were followed up for 6 to 61 （24.0±13.6）months. Twenty-two patients survived, the other 19 patients died. The 1-year, 2-year, 3-year, 4-year, and 5-year survival rate was 80.49%, 39.02%, 21.95%, 7.32%, and 4.88%, respectively. The median survival of single surgical treatment and postoperative comprehensive treatment was 12.0 months and 25.0 months, respectively. The median survival of T2-T4 and T, was 20.0 months and 37.5 months, respectively. The difference was statistically different （P〈0.05）. Cox regression analysis showed that the depth of tumor invasion, postoperative adjuvant chemotherapy and radiotherapy were independent factors of prognosis （P〈0.05）. Conclusions with a high degree of malignancy. It is expected to increase Neuroendocrine carcinoma of the esophagus is rare and the long-term survival rate after surgical and postoperative comprehensive treatment.