首发为食管鳞癌的多原发癌患者临床特征及生存分析

doi:10.12047/j.cjap.6020.2021.008

摘要/Abstract

摘要： 目的: 回顾性分析首发癌为食管鳞癌的多原发癌(ESCCFPM)患者的肿瘤临床特点以及生存预后等临床信息,更好的了解食管鳞癌与其他癌症之间的联系,为指导临床诊治提供相应依据。方法: 收集美国国立癌症研究所监测、流行病学和结果数据库(SEER)2004 年1月1日至2016年12月31日ESCCFPM患者临床资料,Kaplan-Meier法进行生存分析并绘制生存曲线图,Log-Rank检验评估各曲线间的差异。生存预后则采用COX比例风险回归模型进行分析。结果: 540例ESCCFPM患者,其中双原发癌491例,三原发癌42例,四原发癌7例。ESCCFPM患者好发于男性,以61～80岁为高发年龄段。食管鳞癌后第二原发癌好发于呼吸系统(36.9%),其次是消化系统(35.2%)及生殖系统(8.9%);本研究病例的1年、3年和5年的总生存率分别为75.9%、50.4%和38.9%。食管鳞癌确诊时年龄、T分期、多原发癌发病间隔分组、多原发癌数目、手术治疗、淋巴结切除、放疗及化疗可影响ESCCFPM患者预后。而年龄、种族、T分期、多原发癌发病间隔分组、多原发癌数目、手术及放疗是影响ESCCFPM患者预后的独立危险因素。结论: 首发癌为食管鳞癌的多原发癌患者,以双原发癌为主,并发呼吸系统及消化系统肿瘤常见,对于年龄在61～80岁的ESCCFPM患者,加强呼吸及消化道肿瘤的随访可能有助于识别多原发癌。手术及放化疗可能提高患者总生存率。

关键词: 食管鳞癌, 多原发癌, SEER, 同时性多原发癌, 异时性多原发癌

Abstract: Objective: To retrospectively analyze the clinical characters and prognosis of the patients with Esophageal Squamous Cell Carcinomas as First Primary Malignancy (ESCCFPM), which will help us better understand the relationship between Esophageal Squamous Cell Carcinoma (ESCC) and other cancers, and to provide appropriate research evidence for the clinical diagnosis and treatment. Methods: The clinicopathological and follow-up data of 540 Patients with ESCCFPM between January 1, 2004 and December 31, 2016 were collected from the Surveillance, Epidemiology and End Results (SEER) database of National Cancer Institute. The Kaplan-Meier method was used to determine Overall Survival (OS) curves of ESCC patients, and the Log-Rank test was used to estimate differences in survival. The Cox proportional hazards models were adopted for the prognosis analyses. Results: Regarding the number of multiple primary malignancies (MPMs), 491 had two malignancies, 42 had three malignancies and 7 had four malignancies. ESCCFPM is more common among males. The high incidence age is between 61 and 80 years old. Tumors of the respiratory system (36.9%), were the most common MPMs followed by digestive system (35.2%) and reproductive system (8.9%). The 1-year, 3-year, 5-year OS rates for patients with ESCCFPM were 76.9%, 50.4% and 38.9%, respectively. The age of the ESCC diagnosed, T stage, time of occurrence, carcinoma number, lymph node dissection, surgery, radiotherapy and chemotherapy were the prognostic factor of overall survival for ESCCFPM patients. Age, race, T stage, time of occurrence surgery and radiotherapy were independent prognostic factors for the whole cohort by multivariate survival analysis. Conclusion: ESCCFPM,mainly two-lesion cancer, is most commonly found in respiratory system and digestive systems. Enhanced follow-up of respiratory and digestive tumors in ESCCFPM patients aged 61-80 may help identify multiple primary malignancies. Surgery, radiotherapy and chemotherapy may improve overall survival for ESCCFPM patients.

Key words: esophageal squamous cell carcinoma, multiple primary cancers, SEER, synchronous primary malignancy, metachronous primary malignancy

中图分类号:

R735.1

文珍, 张彦秋, 吴蓉, 彭雪梅, 陈彬, 冷爱民. 首发为食管鳞癌的多原发癌患者临床特征及生存分析[J]. 中国应用生理学杂志, 2021, 37(4): 407-414.

WEN Zhen, ZHANG Yan-qiu, WU Rong, PENG Xue-mei, CHEN Bin, LENG Ai-min. Clinical and prognostic features of the patients with esophageal squamous cell carcinomas as a first primary malignancy[J]. CJAP, 2021, 37(4): 407-414.

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