CAJ | 학술논문

目的分析pN0期胸段食管鳞状细胞癌术后复发转移的相关危险因素.方法回顾性分析2004年1月至2010年12月连续收治的112例pN0期胸段食管鳞状细胞癌患者临床病理资料.其中男性92例,女性20例；年龄36 ～ 80岁,平均60.3岁.对患者的随访资料进行分析,多因素分析采用Cox比例风险回归模型判定术后3年内复发转移的独立危险因素.结果术后3年内复发转移率为40.2％(45/112),中位复发转移时间为17.4个月.其中局域性复发38例(33.9％,占复发转移总例数的84.4％),血行转移7例(6.3％).不同肿瘤位置、组织学分化程度、pT分期及病理分期的患者复发转移率差异有统计学意义(x2 =6.380～ 18.837,P＜0.05).多因素分析结果显示,肿瘤位于胸上中段(RR=1.092,P =0.049)和pT3-4a期(RR=3.296,P=0.017)为pN0期胸段食管鳞状细胞癌术后局域性复发转移的独立危险因素.结论 pN0期食管鳞状细胞癌患者术后3年内出现肿瘤复发转移以局域性复发转移最常见.肿瘤位于胸上中段和pT3-4a期是pN0胸段食管鳞状细胞癌术后局域性复发转移的独立危险因素.
목적 분석pN0기흉단식관린상세포암술후복발전이적상관위험인소.방법 회고성분석2004년1월지2010년12월련속수치적112례pN0기흉단식관린상세포암환자림상병리자료.기중남성92례,녀성20례；년령36 ～ 80세,평균60.3세.대환자적수방자료진행분석,다인소분석채용Cox비례풍험회귀모형판정술후3년내복발전이적독립위험인소.결과 술후3년내복발전이솔위40.2％(45/112),중위복발전이시간위17.4개월.기중국역성복발38례(33.9％,점복발전이총례수적84.4％),혈행전이7례(6.3％).불동종류위치、조직학분화정도、pT분기급병리분기적환자복발전이솔차이유통계학의의(x2 =6.380～ 18.837,P＜0.05).다인소분석결과현시,종류위우흉상중단(RR=1.092,P =0.049)화pT3-4a기(RR=3.296,P=0.017)위pN0기흉단식관린상세포암술후국역성복발전이적독립위험인소.결론 pN0기식관린상세포암환자술후3년내출현종류복발전이이국역성복발전이최상견.종류위우흉상중단화pT3-4a기시pN0흉단식관린상세포암술후국역성복발전이적독립위험인소.
Objective To analyze the clinical and pathologic influencing factors of early recurrence in patients with histological node-negative (pN0 stage) esophageal squamous cell carcinoma after radical esophagectomy.Methods A retrospective study on 112 consecutive pN0 stage esophageal squamous cell carcinoma patients who underwent esophagectomy with lymphadenectomy by the same surgical team from January 2004 to December 2010.There were 92 male and 20 female patients,aging from 36 to 80 years with a mean age of 60.3 years.The Cox proportional hazards model was used to determine the independent risk factors for recurrence within 3 years after the operation.Results Recurrence was recognized in 45 patients (40.2％) within 3 years after operation.The median time to tumor recurrence was 17.4 months.Locoregional recurrence was found in 38 patients (33.9％),and hematogenous metastasis in 7 patients (6.3％).Recurrence closely correlated with tumor location,grade of differentiation,pT stage and pathologic stage (x2 =6.380 to 18.837,P ＜ 0.05).The Cox multivariate analysis showed that tumor location (RR =1.092,P =0.049) and pT3-4a stage (RR =3.296,P =0.017) were independent risk factors for postoperative locoregional recurrence.Conclusions The most common recurrence pattern of patients with pN0 esophageal squamous cell carcinoma would develop recurrence within 3 years after operation is locoregional recurrence.Upper/middle thoracic location and pT3-4a stage are independent risk factors for locoregional recurrence of pN0 esophageal squamous cell carcinoma after operation.