摘要
目的分析食管癌脑转移的危险因素及生存状况。方法回顾性分析2005年1月—2019年1月西安交通大学第二附属医院收治的2 563例食管癌患者的临床资料。使用单因素分析脑转移组与非脑转移组患者的临床病理特征,并进行多因素Logistic回归分析,通过Kaplan-Meyer生存曲线和Log-rankχ2检验比较组间生存时间的差异。结果 2 563例食管癌患者中,脑转移48例(1.87%)。脑转移与非脑转移组的年龄、病理类型、T分期、N分期、颅外转移发生率、伴肺转移发生率、伴肝转移发生率比较,差异均有统计学意义(P <0.05)。多因素分析结果显示,T4期、N2期和N3期、伴肺转移是食管癌脑转移的独立危险因素(P <0.05);脑转移组1年生存率为18.64%,低于非脑转移组的86.93%(P <0.05);单因素和多因素分析结果显示,脑转移数目≥3个、原发灶控制不稳定是影响食管癌脑转移患者生存时间的独立危险因素(P <0.05),其中手术综合治疗是保护性因素(P <0.05)。结论 T4期、N2期和N3期、伴肺转移的食管癌患者更容易发生脑转移,生存状况较差,手术综合治疗在增加生存获益上具有优势。
Objective To analyze the risk factors for brain metastasis from esophageal carcinoma and survival status of the patients. Methods We retrospectively analyzed the clinical data of 2563 patients with esophageal carcinoma admitted to the Second Affiliated Hospital of Xi’an Jiaotong University from January 2005 to January 2019. Univariate analysis was performed to investigate the clinicopathological characteristics in the brain metastasis group and the non-brain metastasis group, and multivariate Logistic regression model was applied to analyze influencing factors for brain metastasis. Kaplan-Meier curve and log-rank test were used to compare the difference in survival time between the groups. Results Among 2563 patients with esophageal carcinoma, there were 48 cases(1.87%) with brain metastasis. The age, pathological type, T stage, N stage, incidence of extracranial metastasis, incidence of lung metastasis and incidence of liver metastasis were different between brain metastasis group and non-brain metastasis group(P < 0.05). Multivariate analysis showed that stage T4, N2 and N3 and lung metastasis were independent risk factors for brain metastasis from esophageal carcinoma(P < 0.05). The 1-year survival rate of the brain metastasis group was 18.64%, which was significantly lower than that of the non-brain metastasis group(86.93%)(P < 0.05). Univariate and multivariate analysis showed that the number of brain metastases ≥3 and the instability of primary foci were independent risk factors for the median survival time of patients with brain metastasis from esophageal carcinoma(P < 0.05), while comprehensive surgical treatment was a protective factor(P < 0.05). Conclusions Patients with stage T4 and N2 or N3 esophageal carcinoma and lung metastasis are more likely to develop brain metastasis and show poor survival status. The comprehensive surgical treatment has advantages in increasing survival benefit.
作者
梁君蓉
周永强
刘彦君
胡康
李春燕
邹百仓
Jun-rong Liang;Yong-qiang Zhou;Yan-jun Liu;Kang Hu;Chun-yan Li;Bai-cang Zou(Department of Gastroenterology,The 987th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army,Baoji,Shaanxi 721004,China;Department of Gastroenterology,Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi 610303,China)
出处
《中国现代医学杂志》
CAS
北大核心
2021年第6期85-90,共6页
China Journal of Modern Medicine
基金
陕西省重点研发计划项目(No:2017ZDXM-SF-25-5)。
关键词
食管癌
脑转移
危险因素
生存
预后
esophageal carcinoma
brain metastasis
risk factors
survival
prognosis
