Survival Analysis of Premenopausal,Perimenopausal and Postmenopausal Female Patients with Esophageal Cancer
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摘要: 目的 探讨女性食管癌患者绝经前期、围绝经期和绝经后期生存期差异及其与肿瘤浸润程度和淋巴结转移的关系。方法 通过入户或电话问卷调查及生存随访，采用卡方检验、Kaplan-Meier 生存曲线和Log rank检验及Cox生存分析模型分析1973—2012年间女性绝经前期、围绝经期和绝经后期食管癌患者的生存差异及主要影响因素。结果 女性食管癌患者绝经前期（诊断年龄＜46岁，n=201）、围绝经期（46~55岁，n=949）和绝经后期（≥56岁，n=3 284）生存期依次明显降低（P ＜0.001）；但是三组间肿瘤浸润程度（T）比较差异无统计学意义（P=0.243），而淋巴结转移阳性率依次明显升高（P=0.022）。Cox多因素生存分析提示，绝经状态、淋巴结转移和浸润程度是影响食管癌患者预后的独立因素。结论 绝经状态是影响女性食管癌患者生存期的独立因素，绝经前期、围绝经期和绝经后期女性患者淋巴结转移阳性率依次明显升高。Abstract: Objective To explore the survival difference among premenopausal, perimenopausal and postmenopausal female and the relationship between menopausal status and invasion and lymph node metastasis in esophageal cancer. Methods The questionnaire, home interview and/or telephone were performed for survival follow-up on esophageal cancer patients. The Chi-square test, Kaplan-Meier survival curve,Log rank test and multivariate Cox regression model were applied to assess the survival of all female esophageal cancer from 1973 to 2012. Results The survival time in premenopausal patients (age of diagnosis <46 years, n=201), peri-menopausal (age of diagnosis 46-55 years, n=949) and postmenopausal (age of diagnosis>56 years, n=3 284) were signifi cantly decreased successively (P <0.001). It was noteworthy that the tumor invasion (T) was no difference in premenopausal, perimenopausal or postmenopausal (P=0.243), however, the lymph node metastasis rate was successively increased successively in premenopausal, perimenopausal and postmenopausal (P=0.022). Cox multivariate survival analysis showed that menopausal status, lymph node metastasis and invasion were independent prognostic factors in female patients with esophageal cancer. Conclusion Menopausal status was independent prognostic factor for female patients with esophageal cancer. Lymph node metastasis was related to menopausal status.
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Key words:
- Esophageal cancer /
- Female /
- Menopause /
- Survival time
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[1] Ferlay J,Shin HR,Bray F,et al.Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008[J]. Int J Cancer,2010,127 (12) :2893-917. [2] Parkin DM,Bray F,Ferlay J,et al.Global cancer statistics, 2002[J]. CA Cancer J Clin,2005,55(2):74-108. [3] Bohanes P, Yang D, Chhibar RS, et al. Influence of sex on the survival of patients with esophageal cancer[J]. J Clin Oncol,2012, 30 (18):2265-72. [4] Bodelon C, Anderson GL, Rossing MA, et al. Hormonal factors and risks of esophageal squamous cell carcinoma and adenocarcinoma in postmenopausal women[J]. Cancer Prev Res (Phila),2011,4(6):840-50. [5] Yu H, Liu G, Zhao P, et al. Hormonal and reproductive factors and risk of esophageal cancer in Chinese postmenopausal women: a case-control study[J]. Asian Pac J Cancer Prev,2011,12(8):1953-6. [6] Trévoux R,De Brux J, Castanier M, et al. Endometrium and plasma hormone profile in the peri-menopause and postmenopause[ J] Maturitas, 1986,8(4): 309-26. [7] Chen SJ,Li GW,Xu SL.An Associated agents investigate about woman fi rst menotrual and menopause age (a report of 589,100 cases)[J]. Chongqing Yi Xue,1995,24(5):257-9.[陈水娟,李国维, 徐赛莉.女性初潮年龄、绝经年龄与有关因素调查（附589100 例分析） [J].重庆医学,1995,24(5):257-9.] [8] Nie GN,Wang XY,Yang HY, et al.The research on the factors affecting the timing of natural menopause in Chinese city women[J].Zhongguo Fu You Bao Jian,2011,26(8):1191-3.[聂广宁, 王小云,杨洪艳,等.中国城市女性绝经年龄影响因素调查[J].中 国妇幼保健,2011,26(8):1191-3.] [9] Mellemkjaer L,Friis S,Olsen JH,et al.Risk of second cancer among women with breast cancer[J].Int J Cancer,2006,118(9):2285-92. [10] Zou XN. Epidemiological characteristics of esophageal cancer [J]. Zhonghua Zhong Liu Za Zhi,2006,13(18):1-4. [邹小农. 食管癌流 行病学[J].中华肿瘤防治杂志,2006,13(18):1-4.] [11] Ueo H, Matsuoka H, Sugimachi K, et al. Inhibitory effects of estrogen on the growth of a human esophageal carcinoma cell line[J]. Cancer Res,1990,50(22):7212-5. [12] Yamashita Y, H i r a i T,Mukaida H,e t a l.Detection of androgen receptors in human esophageal cancer[J].Jpn J Surg,1989,19(2):195-202.
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