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目的:探讨影响食管癌术后预后的相关因素,为预后评估和临床治疗提供决策依据。方法:收集经病理确诊的208例食管癌患者的临床资料,随访其5年生存情况。采用kaplan-meier法计算生存率,多因素Cox比例风险回归分析进行筛选和评价独立预后因素,绘制生存曲线。结果:(1)208例食管癌患者术后1年、3年和5年生存率分别为78.8%、57.7%和49.0%,平均生存时间为39.606(95%CI:36.509-42.703)个月。(2)单因素分析显示,不同淋巴结转移数、临床分期、侵犯层次、分化程度、肿瘤长度和手术方式患者5年生存率差异有统计学意义,淋巴结转移数目越多,临床分期越高、侵犯层次越深、分化程度越低和采取姑息手术者的5年生存率越低,P<0.05。(3)多因素Cox比例风险回归分析显示,淋巴结转移数(RR=1.524)、临床分期(RR=1.697)、侵犯深度(RR=2.258)和肿瘤分化程度(RR=1.394)入选以5年死亡风险模型。结论:淋巴结转移数、临床分期、侵犯深度和肿瘤分化程度是食管癌术后预后的重要影响因素,早诊早治是降低食管癌死亡率的主要手段。
Objective: To explore the related factors that influence the postoperative prognosis of esophageal cancer and provide the basis for decision-making on prognosis evaluation and clinical treatment. Methods: The clinical data of 208 patients with esophageal cancer confirmed by pathology were collected and followed up for 5 years. The kaplan-meier method was used to calculate the survival rate, multivariate Cox proportional hazards regression analysis was used to screen and evaluate the independent prognostic factors, and the survival curves were drawn. Results: (1) The 1-year, 3-year and 5-year survival rates of 208 patients with esophageal cancer were 78.8%, 57.7% and 49.0% respectively. The mean survival time was 39.606 (95% CI: 36.509-42.703) months. (2) Univariate analysis showed that the 5-year survival rate of patients with different lymph node metastasis, clinical stage, invasion level, degree of differentiation, tumor length and surgical method had statistical significance. The more lymph node metastasis, the higher the clinical stage, the violation The deeper the level, the lower the degree of differentiation and the lower the 5-year survival rate of those who took palliative surgery, P <0.05. (3) Multivariate Cox proportional hazards regression analysis showed that the number of lymph node metastases (RR = 1.524), clinical stage (RR = 1.697), depth of invasion (RR = 2.258) and tumor differentiation (RR = 1.394) Risk model. Conclusion: The number of lymph node metastasis, clinical stage, depth of invasion and tumor differentiation are important prognostic factors of esophageal cancer. Early diagnosis and treatment of esophageal cancer are the main means to reduce the mortality of esophageal cancer.