T1b期食管鳞癌淋巴结转移及预后危险因素分析

赵莉; 侯滨芬; 邓敏

doi:10.13898/j.cnki.issn.1000-2200.2022.04.011

T1b期食管鳞癌淋巴结转移及预后危险因素分析

Analysis of the lymph node metastasis and prognostic risk factors of stage T1b esophageal squamous cell carcinoma

摘要

摘要:
目的探究T1b期食管鳞癌病人淋巴结转移危险因素及预后独立危险因素。
方法回顾性分析采用根治性手术加淋巴结清扫的T1b食管癌的140例食管鳞癌病人的临床资料，根据术后病理结果将病人分为淋巴结阳性组和淋巴结阴性组, 分析淋巴结转移及影响预后因素。
结果140例病人中淋巴结阳性组20例，淋巴结阴性组120例，淋巴结转移率为14.3%, 单因素分析显示2组年龄、肿瘤分化程度和肿瘤直径差异均有统计学意义(P < 0.05)。多因素分析示，年龄≥55岁、中低分化和肿瘤直径≥5 cm是淋巴结转移独立危险因素(P < 0.05~P < 0.01)。随访时间58(3~127)个月, 失访9例, 死亡15例，存活率为98.2%。T1b期淋巴结阳性组食管鳞癌病人3年及5年生存率分别为84.7%、73.3%，阴性组分别为98.2%、96.9%。淋巴结阳性组的生存率明显低于淋巴结阴性组(P < 0.01)。COX多因素分析显示, 淋巴结转移及女性是影响T1b期食管鳞癌病人预后的独立危险因素(P < 0.05和P < 0.01)。
结论年龄≥55岁、中低分化、肿瘤直径≥5 cm是1b期食管鳞癌病人淋巴结转移的高风险独立因素。淋巴结转移及女性是影响T1b期食管鳞癌病人预后的独立危险因素。

Abstract:
ObjectiveTo explore the risk factors and prognostic independent risk factors of lymph node metastasis in stage T1b esophageal squamous cell carcinoma patients.
MethodsThe clinical data of 140 stage T1b esophageal squamous cell carcinoma patients treated with radical surgery combined with lymph node dissection were retrospectively analyzed.The patients were divided into the lymph node positive group and lymph node negative group according to the postoperative pathological results, and the lymph node metastasis and prognostic factors in two groups were analyzed.
ResultsAmong 140 patients, there were 20 cases in the lymph node positive group and 120 cases in the lymph node negative group, and the lymph node metastasis rate was 14.3%.The results of univariate analysis showed that the differences of the age, tumor differentiation and tumor diameter between two groups were statistically significant(P < 0.05).The results of multivariate analysis showed that the age ≥55 years, medium and low differentiation and tumor diameter ≥5 cm were the independent risk factors of lymph node metastasis(P < 0.05 to P < 0.01).During 58(3-127) months of following-up, 9 cases were lost to follow-up and 15 cases died, and the survival rate was 98.2%.The 3-year and 5-year survival rates in the stage T1b lymph node positive group and negative group were 84.7% & 73.3% and 98.2% & 96.9%, respectively.The survival rate in lymph node positive group was significantly lower than that in lymph node negative group(P < 0.01).The results of COX multivariate analysis showed that the lymph node metastasis and female were the independent risk factors of prognosis of stage T1b esophageal squamous cell carcinoma patients(P < 0.05 and P < 0.01).
ConclusionsThe age≥55 years, moderate and low differentiation and tumor diameter ≥5 cm are the high-risk independent factors of lymph node metastasis in patients with stage T1b esophageal squamous cell carcinoma.Lymph node metastasis and female are the independent risk factors of prognosis of patients with stage T1b esophageal squamous cell carcinoma.

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