转移性食管鳞癌化疗患者预后的影响因素分析

Analysis of Influencing Factors of Prognosis in Patients with Metastatic Esophageal Squamous Cell Carcinoma Undergoing Chemotherapy

目的分析转移性食管鳞状细胞癌(ESCC)化疗患者预后的影响因素。方法回顾性分析2019年1月—2022年1月治疗的转移性ESCC 100例的临床资料,患者均接受化疗联合免疫治疗,统计1、2、3年生存情况,根据生存与否分为生存组与预后不良组,收集2组一般资料,并应用Cox回归分析筛选变量,构建Cox比例风险回归预测模型,根据受试者工作特征曲线及曲线下面积评价模型预测能力。结果100例转移性ESCC化疗患者,中位无进展生存期为11.5个月,中位总生存期为17个月,1、2、3年生存率分别为71.00%、46.00%、38.00%。病理N分期、病变长度、贫血、近期疗效完全缓解(CR)+部分缓解(PR)、X线分型蕈伞型、辅助放疗、Rs2227982C/T多态性是转移性ESCC化疗患者预后不良的影响因素。Cox比例风险回归模型对转移性ESCC化疗患者预后不良预测的敏感度、特异度分别为84.21%、93.44%。结论转移性ESCC患者预后较差,而病理N分期、病变长度、贫血、近期疗效CR+PR、X线分型蕈伞型、辅助放疗、Rs2227982C/T多态性是其预后不良的影响因素,构建Cox比例风险回归模型可有效识别ESCC患者预后不良的高危人群。

Objective To analyze the factors influencing the prognosis of chemotherapy in patients with metastatic esophageal squamous cell carcinoma(ESCC).Methods Retrospective analysis was performed on the clinical data of 100 patients with metastatic ESCC treated from January 2019 to January 2022,all of whom received chemotherapy combined with immunotherapy.The 1-,2-and 3-year survival was statistically analyzed,and the patients were divided into survival group and poor prognosis group according to survival.General data of the two groups were collected,and the variables were screened by Cox regression analysis.Cox proportional hazard regression model was constructed,and the predictive ability of the model was evaluated according to receiver operating characteristic(ROC)curve and area under ROC curve(AUC).Results In 100 patients with metastatic ESCC undergoing chemotherapy,the median progression-free survival(PFS)was 11.5 months,the median overall survival(OS)was 17 months,and the 1-,2-and 3-year survival rates were 71.00%,46.00% and 38.00%,respectively.Pathological N stage,lesion length,anemia,short-term complete response(CR)+partial response(PR),X-ray typing of fungotype,adjuvant radiotherapy,Rs2227982C/T polymorphism were the influencing factors for poor prognosis in patients with metastatic ESCC undergoing chemotherapy.The sensitivity and specificity of Cox proportional hazard regression model for predicting poor prognosis in patients with metastatic ESCC undergoing chemotherapy were 84.21%and 93.44%,respectively.Conclusion The prognosis of patients with metastatic ESCC is poor,and pathological N stage,length of lesion,anemia,short-term CR+PR,X-ray typing of fungotype,adjuvant radiotherapy,Rs2227982C/T polymorphism are the factors influencing the poor prognosis.Cox proportional risk regression model can be established to effectively identify the high-risk groups with poor prognosis in ESCC patients.