摘要
目的:分析浅表食管鳞癌患者不同治疗方式疗效及预后影响因素。方法:回顾性收集2016年至2021年在武汉大学人民医院治疗的92例浅表食管鳞癌患者病例资料。依据不同治疗方式分为内镜下黏膜切除术组(n=39)、食管切除术组(n=44)和二次治疗组(n=9),主要观察指标为总生存期(OS)、无瘤生存期(DFS)和3级及以上不良反应发生率。采用Kaplan-Meier法绘制生存曲线并行log-rank检验,采用Cox回归模型分析患者的预后影响因素。结果:入组患者中位OS及DFS均暂未达到,1、3年OS率为94.6%、89.3%,1、3年DFS率分别为93.0%、83.4%。内镜下黏膜剥除术组1、3年OS率均为94.9%,1、3年DFS率分别为94.7%、83.2%。食管切除术组1、3年OS率为92.2%、88.9%,1、3年DFS率分别为90.6%、75.7%。单因素分析结果显示复发(HR=4.228,95%CI为1.135~15.749,Ρ=0.032)、切缘阳性(HR=4.928,95%CI为1.021~23.786,Ρ=0.047)和放疗(HR=14.899,95%CI为3.636~61.046,Ρ<0.001)是患者预后的独立影响因素。3级及以上不良反应事件中狭窄(χ^(2)=7.114,Ρ=0.029)和放射性肺炎具有统计学意义(χ^(2)=14.931,Ρ<0.001)。结论:浅表食管鳞癌患者行内镜下黏膜剥除术和食管切除术效果显著,但内镜下黏膜剥除术具有保留食管、住院时间短、复发后可行食管切除术等优点。
Objective:To analyze the efficacy and prognostic factors of different treatment modalities in pa-tients with superficial esophageal squamous cell carcinoma.Methods:The pathological data of 92 pa-tients with superficial esophageal squamous cell carcinoma treated in Renmin Hospital of Wuhan Uni-versity from 2016 to 2021 were retrospectively collected.According to different treatment methods,the patients were divided into an endoscopic submucosal dissection group(n=39),an esophagectomy group(n=44),and a secondary treatment group(n=9).The main observation indicators were overall survival(OS),disease-free survival(DFS),and the incidence of grade 3 or above adverse reactions.Kaplan-meier method was used to draw the survival curve and the log-rank test was performed.TheCox regression model was used to analyze the prognostic factors of patients.Results:The median OSand DFS were not present in the enrolled patients,the OS rates of 1 year and 3 years were 94.6%and 89.3%,respectively,and the DFS rates of 1 year and 3 years were 93.0%and 83.4%,respec-tively.Both the 1-year and 3-year OS rates in the endoscopic submucosal dissection group were94.9%,the 1-year and 3-year DFS rates were 94.7%and 83.2%,respectively.The 1-year and 3-year OS rates were 92.2%and 88.9%,respectively,in the esophagectomy group,and the 1-yearand 3-year DFS rates were 90.6%and 75.7%,respectively.Univariate analysis showed recurrence(HR=4.228,95%CI:1.135-15.749,P=0.032),positive margin(HR=4.928,95%CI:1.021-23.786,P=0.047)and radiotherapy(HR=14.899,95%CI:3.636-61.046,P<0.001)were inde-pendent prognostic factors.Stenosis(χ^(2)=7.114,P=0.029)and radiation pneumonia were statistical-ly significant in grade 3 and above adverse events(χ^(2)=14.931,P<0.001).Conclusion:Endoscopicsubmucosal dissection and esophagectomy had significant effects on superficial esophageal squamouscell carcinoma patients.However,endoscopic mucosal stripping had the advantages of esophagealpreservation,short hospital stay,and feasible esophagectomy after recurrence.
作者
夏玲玲
汪晶
樊湘力
陈永顺
XIA L ingling;WANG Jing;FAN Xiangli;CHEN Yongshun(Oncology Centre,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China;First Clinical School of Wuhan University,Wuhan 430060,Hubei,China)
出处
《武汉大学学报（医学版）》
CAS
2023年第10期1204-1208,共5页
Medical Journal of Wuhan University
基金
湖北省中央引导地方科技发展专项(编号:2020ZYYD006)。
关键词
浅表食管癌
总生存率
内镜黏膜剥除术
食管切除术
Superficial Esophageal Carcinoma
Overall Survival
Endoscopic Mucosal Strip⁃ping
Esophagectomy
