胸段食管鳞癌患者预后影响的多因素Cox回归分析

The Multivariate Cox Regression Analysis of the Prognosis Influence Factor of Patients with Thoracic Esophageal Squamous Cell Carcinoma

目的:探讨胸段食管鳞癌(esophageal squamous cell carcinoma,ESCC)患者预后的影响因素。方法:选取2014年1月-2016年3月本院收治的胸段ESCC行右胸食管癌根治术患者216例作为研究对象,回顾性分析胸段ESCC患者预后的影响因素。记录所有胸段ESCC患者手术治疗相关病理特征,采用单因素与多因素Cox回归分析探讨阴性淋巴结数目对胸段ESCC患者预后的影响。结果:单因素分析显示,性别、年龄、肿瘤长度、组织分化程度、pT分期、术后辅助治疗、阴性淋巴结数目均是胸段ESCC患者预后的可能影响因素(P<0.05);而不同肿瘤位置胸段ESCC患者预后差异无统计学意义(P>0.05)。以胸段ESCC行右胸食管癌根治术患者预后为因变量进行多因素Cox回归分析,结果显示性别(HR=1.697,95%CI:1.304,2.536)、年龄(HR=1.851,95%CI:1.218,2.969)、肿瘤长度(HR=2.125,95%CI:1.745,2.894)、组织分化程度(HR=1.662,95%CI:1.084,2.235)及pT分期(HR=1.789,95%CI:1.146,3.128)为胸段ESCC患者预后的独立危险因素(P<0.05),而术后辅助治疗(HR=0.611,95%CI:0.372,0.975)、阴性淋巴结数目(HR=0.415,95%CI:0.259,0.823)为胸段ESCC患者预后的独立保护因素(P<0.05)。结论:性别、年龄、肿瘤长度、组织分化程度、pT分期、术后辅助治疗及阴性淋巴结数目均为胸段ESCC患者预后的独立影响因素,针对其进行分析有助于改善胸段ESCC患者预后。

Objective:To explore the influence factor of prognosis of patients with thoracic ESCC.Method:A total of 216 patients with thoracic ESCC who was taken radical resection of right thoracic esophageal carcinoma were selected in our hospital from January 2014 to March 2016 as the research objects,and retrospectively analyzed the influence factor of prognosis of patients with thoracic ESCC.The pathological characteristics of all patients with thoracic ESCC were recorded.Univariate and multivariate Cox regression analysis were used to explore the influence of the number of negative lymph nodes on the prognosis of patients with thoracic ESCC.Result:Univariate analysis showed that gender,age,tumor length,degree of tissue differentiation,pT stage,postoperative adjuvant therapy and the number of negative lymph nodes were all possible influencing factors for the prognosis of patients with thoracic ESCC (P<0.05),but there was no significant difference in the prognosis of patients with thoracic ESCC at different tumor locations (P>0.05).Multivariate Cox regression analysis was performed with the prognosis of patients with thoracic ESCC undergoing right thoracic esophagectomy as the dependent variable.The results showed that gender (HR=1.697,95%CI:1.304,2.536),age (HR=1.851,95%CI:1.218,2.969),tumor length (HR=2.125,95%CI:1.745,2.894),histological differentiation (HR=1.662,95%CI:1.084,2.235) and pT stage (HR=1.789,95%CI:1.146,3.128) were independent risk factors for the prognosis of patients with thoracic ESCC (P<0.05),but postoperative adjuvant therapy (HR=0.611,95%CI:0.372,0.975) and the number of negative lymph nodes (HR=0.415,95%CI:0.259,0.823) were the independent protective factors for the prognosis of patients with thoracic ESCC (P<0.05).Conclusion:Gender,age,tumor length,histological differentiation,pT stage,postoperative adjuvant therapy and the number of negative lymph nodes are independent influencing factors for the prognosis of patients with thoracic ESCC,research for them is helpful to improve the prognosis of patients with thoracic ESCC.