食管鳞癌脑转移患者的临床特征和影响因素及其对生存的影响

Clinical Characteristics and Influencing Factors of Esophageal Squamous Cell Carcinoma Patients with Brain Metastases and Their Influence on Survival

目的探讨食管鳞癌脑转移患者的临床特征、影响因素及其对生存的影响。方法回顾性分析2000年12月—2015年12月我院收治的食管鳞癌脑转移67例患者的临床病理资料,分析食管癌脑转移与临床病理特征及生存率的相关性。结果食管鳞癌脑转移瘤个数与T分期、N分期呈正相关(P<0.05)。全组患者中位生存期为9.65月;Logistic回归分析显示N2、N3分期是食管鳞癌患者发生脑转移的危险因素,N0、N1期患者出现脑转移的风险更低(P<0.05)。Log rank生存分析显示,脑转移瘤个数为1的食管鳞癌患者的预后优于脑转移瘤个数为2和3的患者(P<0.05);N0+N1期患者预后好于N2和N3期的患者(P<0.05);多因素Cox回归模型显示,T3+T4、N3、是否做全脑放疗是影响食管鳞癌脑转移患者的预后独立影响因素(P<0.05)。结论食管鳞癌脑转移瘤数量与T、N分期呈正相关。N分期越晚,脑转移风险越大。T、N分期越晚,食管鳞癌脑转移患者预后越差。全脑放疗可以获得更大的生存获益。

Objective To investigate the clinical characteristics and influencing factors of patients with brain metastases from esophageal squamous cell carcinoma(BM-ESCC)and their impact on survival.Methods We retrospectively analyzed the clinical data of 67 patients with newly diagnosed BM-ESCC from December 2000 to December 2016 in our hospital,to analyze the correlation of brain metastases with clinicopathological characteristics and the survival.Results The number of BM-ESCC was positively correlated with T and N stages(P<0.05).The median survival time was 9.65 months.Logistic regression analysis showed that N2 and N3 were risk factors for brain metastasis in patients with esophageal squamous cell carcinoma,and the risk of brain metastasis in patients with N0 and N1 was lower(P<0.05).Log rank survival analysis reveal that patients with one brain metastasis had a significantly longer survial than those with two and three brain metastasis(P<0.05);patients with N0+N1 stage had better prognosis than those with N2 and N3(P<0.05).Cox regression model showed that T3+T4 stage,N3 stage and whole brain radiotherapy were independent prognostic factors for BM-ESCC patients(P<0.05).Conclusion In esophageal squamous cell carcinoma patients with brain metastases,the number of brain metastases is positively correlated with T and N stages;the higher N stage is,the higher the risk of brain metastases is;the higher T and N stages are,the worse the prognosis is;whole brain radiotherapy could offer better survival benefits.