| 杜泽森,傅俊惠,罗何三.食管癌全系膜切除术后系膜浸润的临床意义[J].肿瘤学杂志,2019,25(8):728-732. |
| 食管癌全系膜切除术后系膜浸润的临床意义 |
| Clinical Significance of Mesoesophagus Invasion in Patients with Esophageal Cancer Treated with Total Mesoesophagus Excision |
| 投稿时间：2018-11-22 |
| DOI：10.11735/j.issn.1671-170X.2019.08.B010 |
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| 中文关键词: 食管肿瘤 全系膜切除 系膜浸润 临床意义 |
| 英文关键词:esophageal cancer TME mesoesophagus invasion clinical significance |
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| 中文摘要: |
| 摘 要：［目的］分析食管癌全系膜切除术后的系膜浸润对患者预后的影响。［方法］ 回顾性分析607例接受食管全系膜切除的食管癌临床资料，分成系膜浸润阳性和阴性两组，比较两组患者的无病生存时间和总生存时间，通过单因素分析和Cox多因素分析，分析影响患者术后生存的预后因素。［结果］ 全组患者1、2、3、5年无病生存率分别为78.2%、61.3%、53.9%和48.8%，1、2、3、5年总生存率分别为87.2%、68.8%、59.0%和49.5%，食管系膜浸润阴性患者无病生存和总生存均显著优于食管系膜浸润阳性患者（P<0.001）。单因素分析显示，肿瘤病理分级、T分期、N分期、TNM分期和食管系膜浸润是影响患者术后无病生存时间的相关因素（P<0.05），肿瘤病理分级、肿瘤定位、T分期、N分期、TNM分期和食管系膜浸润是影响患者术后总生存时间的主要因素（P<0.05）。Cox多因素分析显示，T分期、N分期和系膜浸润是影响患者术后无病生存时间和术后总生存时间的独立预后因素（P<0.05）。［结论］食管癌全系膜切除术可获得良好的局部控制和远期生存，食管系膜浸润是患者术后生存的独立预后因素，对患者预后判断和辅助治疗选择具有重要参考价值。 |
| 英文摘要: |
| Abstract：［Objective］ To explore the clinical significance of mesoesophagus invasion in patients with esophageal cancer treated with total mesoesophagus excision(TME). ［Methods］ Six hundred and seven patients with esophageal cancer treated with TME were retrospective analyzed. The disease-free survival(DFS) and overall survival(OS) time were compared between patients with positive or negative mesoesophagus invasion. Univariate analysis and multivariate Cox regression analysis were performed to estimate the prognostic factors for patients treated with TME. ［Results］ Among 607 patients there were 106 cases of positive mesophagus invasion(17.5%) and 501 cases of negative mesophagus invasion(82.5%). The 1-，2-，3-and 5-years DFS and OS rates of all patients were 78.2%，61.3%，53.9% and 48.8%，and 87.2%，68.8%，59.0% and 49.5%，respectively. The DFS and OS of the mesoesophagus invasion negative group were significantly higher than those of the positive group(P<0.001). In univariate analysis，grade，T stage，N stage，TNM stage and mesoesophagus invasion were significant correlated with the DFS(all P<0.05)，while grade，tumor location，T stage，N stage，TNM stage and mesoesophagus invasion were significant correlated with OS(all P<0.05). The Cox regression model showed that T stage，N stage and mesoesophagus invasion were significant correlated with DFS and OS(all P<0.05). ［Conclusion］ Patients with esophageal cancer treated with TME show good local control and long-term survival. Furthermore，mesoesophagus invasion is an independent prognostic factor for patients treated with TME，indicating its importance in outcome prediction and adjuvant therapy selection for these patients. |
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