摘要
目的:探讨淋巴结和血道转移与食管腺癌临床病理特征及预后的关系。方法:从郑州大学第一附属医院河南省食管癌重点开放实验室70万例食管癌患者临床病理和随访(1973至今)大资料库中,选取600例食管腺癌患者。对淋巴结转移(LNM)、脉管癌栓(VTE)阳性和阴性患者的临床病理特征进行比较,采用Kaplan-Meier和Cox回归分析探讨两者与预后的关联性。结果:600例中LNM 340例(56.7%),存在VTE 262例(43.7%)。LNM阳性(LNM+)组男性、吸烟史、饮酒史、家族史阳性、胸下段、低分化和T3/T4期患者比例大于阴性(LNM-)组(P<0.05);VTE阳性(VTE+)组男性、高发区、家族史阳性、胸下段、低分化、T3/T4期患者比例大于阴性(VTE-)组(P<0.05)。LNM^(+)VTE^(+)患者213例,LNM^(-)VTE^(-)患者211例,LNM^(+)VTE^(-)患者127例,LNM^(-)VTE^(+)患者49例。LNM^(-)VTE^(-)组预后优于LNM^(+)VTE^(-)和LNM^(+)VTE^(+)组(P均<0.001)。Cox回归结果显示,在调整多种因素后,与LNM^(-)VTE^(-)相比,LNM^(-)VTE^(+)、LNM^(+)VTE^(-)、LNM^(+)VTE^(+)食管腺癌患者死亡风险增加,HR(95%CI)分别为1.496(0.980~2.285)、2.019(1.483~2.748)、2.642(2.013~3.467)。结论:LNM、VTE与食管腺癌死亡风险有关,两者应纳入预后评估体系。
Aim:To investigate the association of lymph node and hematogenous metastasis with the clinicopathological feature and prognosis of esophageal adenocarcinoma(EAC)in China.Methods:Totally 600 cases with EAC were selected from the database of clinical pathology and follow-up(since 1973)of 700000 cases of esophageal cancer patients in Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital of Zhengzhou University.The clinicopathological features of patients with positive and negative lymph node metastasis(LNM)or vascular tumour embolism(VTE)were compared.Kaplan-Meier and Cox regression analysis were used to explore the association of both with the prognosis of EAC.Results:Out of the 600 cases,LNM was identified in 340 cases(56.7%),while VTE in 262 cases(43.7%).The proportions of male patients,those with smoking history,drinking history,family history,lower thoracic segment,poorly differentiation and T3/T4 stage in the LNM positive group were greater than those in the negative group(P<0.05).The proportions of male patients,those at high-incidence areas,those with family history,lower thoracic segment,poorly differentiation and T3/T4 stage in the VTE positive group were greater than those in the negative group(P<0.05).There were 213 cases of LNM^(+)VTE^(+),211 cases of LNM^(-)VTE^(-),127 cases of LNM^(+)VTE^(-),and 49 cases of LNM^(-)VTE^(+).The prognosis of the LNM^(-)VTE^(-)group was better than that of the LNM^(+)VTE^(-)and LNM^(+)VTE^(+)groups(P<0.001).Cox regression analysis showed that after adjusting for multiple factors,compared with LNM^(-)VTE^(-),LNM^(-)VTE^(+),LNM^(+)VTE^(-),and LNM^(+)VTE^(+)patients had increased risk of death,with HR(95%CI)of 1.496(0.980-2.285),2.019(1.483-2.748),and 2.642(2.013-3.467).Conclusion:LNM and VTE may be associated with the death risk for EAC and should be included in the prognostic assessment system.
作者
王立东
陶潇龙
宋昕
高慧丽
张晓倩
赵学科
卢玉娴
张占阳
王苒
范宗民
韩雪娜
尹艳春
雷玲玲
韩文莉
秦富强
李爱丽
王献增
王五洲
李吉林
马磊
徐全晓
罗宏
李秀敏
张冬云
纪爱芳
WANG Lidong;TAO Xiaolong;SONG Xin;GAO Huili;ZHANG Xiaoqian;ZHAO Xueke;LU Yuxian;ZHANG Zhanyang;WANG Ran;FAN Zongmin;HAN Xuena;YIN Yanchun;LEI Lingling;HAN Wenli;QIN Fuqiang;LI Aili;WANG Xianzeng;WANG Wuzhou;LI Jilin;MA Lei;XU Quanxiao;LUO Hong;LI Xiumin;ZHANG Dongyun;JI Aifang(Henan Key Laboratory for Esophageal Cancer Research,National Key Laboratory of Metabolism Disorder and Esophageal Cancer Prevention and Treatment,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052;School of Medical Sciences,Zhengzhou University,Zhengzhou 450052;Department of Ophthalmology,Linzhou Tumor Hospital,Linzhou,Henan 456550;Department of Oncology,Linzhou Tumor Hospital,Linzhou,Henan 456550;Department of Thoracic Surgery,Linzhou People′s Hospital,Linzhou,Henan 456550;Department of Neurology,Linzhou People′s Hospital,Linzhou,Henan 456550;Department of Pathology,Linzhou People′s Hospital,Linzhou,Henan 456550;Tumor Laboratory,the First People′s Hospital of Nanyang,Nanyang,Henan 473000;Department of General Surgery,Guangshan County People′s Hospital,Guangshan,Henan 465499;Xinxiang Key Laboratory of Tumor Molecular Therapy,Xinxiang Medical College,Xinxiang,Henan 453003;Department of Pathology,Nanyang Medical College,Nanyang,Henan 473000;Department of Clinical Laboratory,Heping Hospital Affiliated to Changzhi Medical College,Changzhi,Shanxi 046000)
出处
《郑州大学学报(医学版)》
北大核心
2025年第4期473-477,共5页
Journal of Zhengzhou University(Medical Sciences)
基金
国家科技重大专项(2024ZD0520906)
国家自然科学基金项目(U1301227)
河南省科技攻关项目(232102311032)。
关键词
食管腺癌
淋巴结转移
血道转移
脉管癌栓
esophageal adenocarcinoma
lymph node metastasis
hematogenous metastasis
vascular tumour embolism
