摘要
目的：探讨食管梭形细胞癌（ESSC）患者的临床病理特征和生存影响因素。方法：对286例ESSC患者的临床信息进行回顾性分析。结果：ESSC患者在同期食管恶性肿瘤中的检出率为0.11%（286/251 707）,男女性别比例为2.11GA6FA1,男性中位年龄61岁,女性中位年龄62岁。术前病理活检112例,正确率50.9%。ESSC主要发生于食管中段（69.1%）,其次为下段（18.8%）; 大体类型以腔内型为主（35.5%）,其次为蕈伞型（25.2%）、髓质型和溃疡型（12.9%和12.3%）; 淋巴结转移率仅为26.3%; 远器官转移率为2.1%; T分期早期ESSC（T1N0M0）的检出率高达31.7%。临床早期和中晚期患者5 a生存率分别为54.5%和43.7%。Cox回归分析结果显示T分期与M分期是ESSC预后的独立影响因素[β=0.390,1.588; OR（95%）=1.477（1.181～1.847）,4.748（1.666～13.530）]。结论：ESSC以男性为主,多发于食管中段,术前活检诊断正确率较低,大体类型以腔内型为主,较少发生淋巴结转移。浸润程度和远器官转移是影响ESSC预后的独立因素。
Aim： To characterize the clinicopahological changes and survival impact factors of esophagus spindle cell carcinoma（ESSC）.Methods： All the clinical epidemiological information from 286 ESSC patients was retrospectively analyzed.Results： The detection rate of ESSC in the present database was 0.11%（286/251 707）. The sex ratio of male vs. female was 2.11GA6FA1.The male median age was 61 years,and the female median age was 62 years. A total of 112 cases were performed pathological biopsy and the accuracy was 50.9%.The most common site for ESSC was in the middle segment of the esophagus（69.1%）, followed by the lower segment（18.8%）. The most common gross tumor type of ESCC was intraluminal type（35.5%）, followed by fungating type（25.2%）, medullary type（12.9%）and ulceration type（12.3%）.The local lymph node metastasis rate was 26.3%; only 2.1% of the ESSC patients occurred long distance organ metastasis. The early ESSC（T1N0M0）accounted for 31.7%. The five-year survival rate for early and advanced ESSC was 54.5% and 43.7%, respectively. Cox proportional hazards regression model analysis showed that T and M phase were the independent risk factors for poor prognosis of ESSC[β=0.390,1.588; OR（95%）=1.477（1.181-1.847）,4.748（1.666-13.530）].Conclusion： ESSC predominantly occurs in males and in the middle segment of the esophagus,and with a higher misdiagnosis before operation. The intraluminal type is the most common gross tumor type, and the incidence of lymph node metastasis is low. T and M phase are the independent risk factors for poor prognosis of ESSC.
作者
姬玲粉
范宗民
吴敏杰
王苒
孔国强
孟辉
周英发
刘太江
刘志才
付文婷
伍玥
程让
王立东
Jl Lingfen FAN Zongmin WU Minjie WANG Ran KONG Guoqiang MENG Hui ZHO U Ying- fa LIU Taijiang LIU Zhicai FU Wenting WU Yue CHENG Rang WANG Lidong(Henan Key Laboratory for Esophageal Cancer Research, the First Affiliated Hospital, Zhengzhou Universi- ty, Zhengzhou 450052 Department of Pathology and PathophysioIogy, Basic Medical College, Xinx- iang Medical University, Xinxiang 453003 Department of Pathology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052 Department of Gastroenterology, the Second Affiliated Hospi- tal, Zhengzhou University, Zhengzhou 450052 Department of Surgery, the Red Cross Hospital of Huofia County, Huojia 453800 Department of Thoracic Surgery, Tumor Hospital of Linzhou, Linzhou 456550 Department of Gastroenterology, Henan Provincial People＇s Hospital, Zhengzhou 450003)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2016年第5期565-568,共4页
Journal of Zhengzhou University(Medical Sciences)
基金
国家自然科学基金委员会和广东省联合重大项目资助U1301227
国家科技部863重点专项资助SQ2015AA0202183
河南省科技计划项目142300410204
关键词
食管梭形细胞癌
临床流行病学
病理诊断
生存分析
esophagus spindle cell carcinoma
clinical epidemiology
pathological diagnosis
survival analysis
作者简介
通信作者，男，1958年8月生，博士，教授，研究方向：食管／贲门癌变机制与防治研究，E-mail：ldwang@zzu．edu．cn
