Comparative Analysis of Clinicopathological Changes in Esophageal Cancer Patients with Ultra-long and Short-term Survival
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摘要: 目的 通过对比分析食管癌超长期（≥10年）和短期（<5年）生存患者临床病理变化，揭示超长期生存患者临床病理特征及相关影响因素。方法 采用问卷调查和住院病历复核，建立超长期生存患者信息资料库；采用SPSS19.0软件、χ2检验和多因素Logistic回归进行统计学处理。结果 临床病理信息完整的食管癌患者共4 008例（超长期2 019例，短期1 989例）。超长期患者平均诊断年龄[男：(53±8.7)岁；女：(54±8.4)岁]明显小于短期患者[（男：(61±8.8)岁；女：(61±8.8)岁]（P<0.05）。超长期生存患者仍以中、晚期为主（男：88%；女：86%），但低于短期生存患者（87% vs. 96%，χ2=69.09，P<0.05），而早期患者是短期的3倍（13% vs. 4%，χ 2=69.09，P<0.05）；高分化患者比短期多2倍（31% vs. 13%，χ2=191.56，P<0.05）；而淋巴结转移患者比短期低2倍（23% vs. 53%，χ2=223.40，P<0.05）；超长期以T2为主，而短期以T3为主（47% vs. 64%, χ2=228.57， P<0.05）；此外，超长期患者家族史阳性率明显高于短期患者（40% vs. 28%，χ2=43.25，P<0.05）；超长期患者单纯手术治疗率明显高于短期者（80% vs. 69%，χ2=72.94，P<0.05）。结论食管癌细胞分化程度和浸润深度、淋巴结有无转移以及患者治疗方式和家族史是影响食管癌预后的主要因素；食管癌细胞呈高分化、无淋巴结转移、家族史阳性和发病年龄早是食管癌患者超长期生存的重要影响因素。Abstract: Objective To determine the key factors favorable for good prognosis by comparing clinicopathological differences between ultra-long (≥10 years, ULS) and short-term survival (<5 years,SS) in esophageal cancer (EC). Methods Home interview and questionnaire were performed in a large-scale mass survey in high-incidence area for EC in He'nan, China. The database of ULS patients was established based on the retrieved clinicopathological information from medical records in The First Affiliated Hospital of Zhengzhou University.Chi-square test and multi-factor logistic model regression were applied for survival analyzed by SPSS19.0 software. Results A total of 4008 patients with EC??including 2019 case with ULS and 1989 case with SS were fi nally enrolled. Compared with SS patients, the mean age at diagnosis of ULS patients was younger (male, 53±8.7 vs.61±8.8; female, 54±8.4 vs. 61±8.8, P<0.05), the ratio of ULS patients in middle and advanced stage was lower (87% vs.96%, χ2 =69.09, P<0.05), the ratio of ULS patients in early stage was 3-folds higher (13% vs.4%, χ2=69.09，P<0.05), the ratio of ULS patients with well-differentiated was 2-folds higher (31% vs.13%, χ2=191. 56, P<0.05), and the ratio of ULS patients with lymph node metastasis was 2-folds lower (23% vs.53%,χ2=223.40,P<0.05). Moreover, T2 stage in ULS patients while T3 stage in SS patients was prominent(47% vs.64%, χ2=228.57,P<0.05). In addition, ULS patients had a higher frequency of family history (40% vs.28%, χ2=43.25, P<0.05) and surgical treatment (80% vs.69%, χ2=72.94，P<0.05). Conclusion Differentiated degree and infiltration depth of esophageal cancer cells, lymph node metastasis, family history and different treatments were the important factors for prognosis of esophageal cancer.The key favorable factors for ULS patients were well-differentiated status, no lymph node metastasis, positive family history and early onset age.
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Key words:
- Esophageal cancer /
- Ultra long-survival /
- Shortsurvival /
- Lymph node metastasis /
- Family history /
- Prognosis
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