食管癌核心家系患者临床病理特征及术后预后分析

Analysis of clinicopathological features and postoperation prognosis of patients from core family of esophageal cancer

目的:分析食管癌核心家系患者的临床病理特征及术后预后影响因素。方法:收集3 260例接受食管癌根治性切除手术的、来自于不同食管癌核心家系的患者的临床病理资料和随访信息,分析食管癌核心家系患者的临床病理特征及术后预后影响因素。结果:3 260例食管鳞癌患者男女比例为1. 7∶1,确诊年龄32～85(60. 2±8. 1)岁,≥60岁者占53. 8%; 88. 8%来自食管癌高发区;肿瘤位于食管中段和下段者占82. 5%;低、中、高分化者分别占26. 6%、61. 9%和11. 5%;切缘净占94. 3%;肿瘤长径<4 cm者占47. 6%; TNM分期(0+Ⅰ)期占15. 2%,Ⅱ、Ⅲ、Ⅳ期者分别占54. 5%、29. 9%和0. 4%。Cox分析结果显示,男性、确诊年龄≥60岁、肿瘤位于食管颈段和上段、分化程度低、肿瘤长径≥4 cm和TNM晚期是食管癌核心家系患者术后预后的独立危险因素,HR(95%CI)分别为1. 119(1. 016～1. 231)、1. 302 (1. 185～1. 429)、1. 345 (1. 186～1. 526)、1. 149 (1. 065～1. 238)、1. 269 (1. 151～1. 400)、1. 666(1. 547～1. 795)。结论:性别、确诊年龄、肿瘤部位、分化程度、肿瘤长径及TNM分期是食管癌核心家系患者术后预后的影响因素。

Aim:To analyze the clinicopathological features and postoperation prognosis of patients from core family of esophageal cancer.Methods:The clinical pathological data and follow-up information of 3 260 esophageal squamous cell carcinoma(ESCC)patients from different core families and undergoing radical resection of esophageal cancer were collected,and the clinicopathological features and prognosis were retrospectively analyzed.Results:Among the 3 260 patients,the ratio of men to women was 1.7∶1,the age at diagnosis was 32-85(60.2±8.1)years,53.8%patients was more than60 years old;88.8%came from the high-incidence area;26.6%,61.9%and 11.5%were with low,medium,and high differentiation,respectively;94.3%had postoperative margin clearance;the patients with tumor long diameter<4 cm accounted for 47.6%;the proportion of the patients with TNM 0+Ⅰ,Ⅱ,Ⅲ,Ⅳstage were 15.2%,54.5%,29.9%and 0.4%,respectively.The results of Cox regression showed that males,age at diagnosis≥60 years,tumor segment+upper segment,low degree of differentiation,tumor long diameter≥4 cm and late TNM stage were the risk factors for the postoperation prognosis,and HR(95%CI)was 1.119(1.016-1.231),1.302(1.185-1.429),1.345(1.186-1.526),1.149(1.065-1.238),1.269(1.151-1.400),1.666(1.547-1.795),respectively.Conclusion:Gender,age at diagnosis,location of tumor,degree of differentiation,length of tumor,and TNM stage may be the influencing factors of postoperation prognosis for ESCC patients from esophageal cancer core family.