肿瘤病理长度在食管鳞状细胞癌预后评估中的意义

Significance of tumor pathological length in evaluation of prognosis of esophageal squamous cell carcinoma

目的 探讨肿瘤病理长度在食管鳞状细胞癌预后评估中的意义.方法 选择421例食管鳞状细胞癌患者作为研究对象.收集各患者性别、年龄、病理检查结果（肿瘤病理长度）、生存期、癌症分期、手术方式等资料.将患者分为两组：≤4 cm组（189例）和〉4 cm组（232例）.比较两组性别、年龄、手术方式、生存率.结果 两组性别构成、年龄构成以及手术方式构成差异均无统计学意义（χ^2=2.03、2.41、0.06,均P〉0.05）;肿瘤病理长度与TNM分期存在相关性（CMH=68.07,P〈0.01）;肿瘤病理长度≤4 cm组生存期的25%、50%、75%分位数分别为28、40、58个月,〉4 cm组分别为19、31、61个月,两组差异有统计学意义（χ^2=44.88,P〈0.01）,肿瘤病理长度≤4 cm组生存率高于〉4 cm组;以TNM分期进一步分层分析,Ⅰ期患者中,肿瘤病理长度≤4 cm组生存率高于〉4 cm组（χ^2=5.61,P〈0.05）;Ⅱ期患者中,肿瘤病理长度≤4 cm组生存率高于〉4 cm组（χ^2=4.62,P〈0.05）;Ⅲ期患者中,肿瘤病理长度≤4 cm组生存率高于〉4 cm组（χ^2=4.88,P〈0.05）.结论 肿瘤病理长度是食管鳞状细胞癌有效预后因子,临界值可定为4 cm.

Objective To explore the clinical significance of tumor pathological length in evaluation of prognosis of esophageal squamous cell carcinoma.Methods 421 patients with esophageal squamous cell carcinoma were selected as study subjects.Each patient＇s data of gender,age,pathological examination（tumor pathological length）,survival time,cancer stage,operation mode were collected.The patients were divided into two groups：≤4 cm group（189 cases） and 〉4 cm group（232 cases）, and the constituent ratios of gender,age,or operation mode and the survival rate between the two groups were analyzed.Results There were no significant differences in gender composition,age structure and operation mode between the two groups（χ^2=2.03,2.41,0.06,all P〉0.05）;There was positive correlation between tumor pathological length and TNM stage（CMH=68.07,P〈0.01）.The 25%,50% and 75% quantiles of survival period in the group whose tumor length was less than or equal to 4 cm were 28,40 and 58 months,respectively,which in the group whose tumor length was more than 4 cm were 19,31 and 61 months,and there was significantly difference between the two groups（χ^2=44.88,P〈0.01）, the group whose tumor length was less than or equal to 4 cm had higher survival rate than the group whose tumor length was more than 4 cm.In the further stratification analysis by TNM stage,the group whose tumor length was less than or equal to 4 cm had higher survival rate than the group whose tumor length was more than 4 cm in theⅠstage patients（χ^2=5.61,P〈0.05）;the group whose tumor length was less than or equal to 4 cm had higher survival rate than the group whose tumor length was more than 4 cm in theⅡstage patients（χ^2=4.62,P〈0.05）;the group whose tumor length was less than or equal to 4 cm had higher survival rate than the group whose tumor length was more than 4 cm in the Ⅲ stage patients（χ^2=4.88,P〈0.05）.Conclusion Tumor pathological length is an effective prognostic factor for esophageal squamous cell carcinoma,and the critical value can be determined as 4 cm.