311例同一个体食管/贲门（胃）双源癌患者临床病理特征及生存影响因素分析

目的通过分析食管鳞癌/贲门（胃）双源癌（CC）患者临床病理特征,探讨影响双源癌患者生存期的关键因素。方法收集来自食管癌高发区的311例双源癌患者资料,从治疗医院获得病理资料,进行生存随访,并分析双源癌患者临床病理特征及影响生存期的因素。结果 1）漏诊率34.7%;男女性别比为4.9∶1;不同性别患者肿瘤类型均以食管鳞癌/贲门腺癌为主;2）食管癌、贲门癌TNM分期均以Ⅱ期为主,Ⅳ期最少,但贲门癌Ⅲ~Ⅳ期明显多于食管癌（P〈0.05）;2种肿瘤分化程度、T分期、N分期及临床分期一致性差（Kappa值均〈0.2）;3）T分期及N分期是影响双源癌患者预后的独立因素（P〈0.05）。结论双源癌患者漏诊率高,病理一致性差,预后影响因素复杂。

Analysis of influencing Factors of Survival and Clinicopathologic Features for 311 Patients with Concurrent Emphageal and Gastric Cardht Carcinoma

Objective To investigate the influencing factors of survival for patients with concurrent esophageal and gastric （eardia） carcinoma by the analysis of chinicopatholgic features. Methods The basic data of 311 pa- tients with concurrent esophagus and gastric（cardia）cancinoma were collected, all the patients were from the high incidence area of esophageal carcinoma, The ctinlcaopathological data were got from hospital, and then a follow-up for survival was taken,The clinicaopathological features of the patients and the factors affecting survival were ana- lyzed. Results 1 ） The rate of missed diagnosis was 34, 7% ; overall sender ratio for male to female was 4.9 ： 1 ; the histological types of tumor was based on esophageal squamous cell carcinoma,/gaatric eardia adenoeareinoma; 2 ） the TNM stage of esophageal squamous cell carcinoma and gastric cardia adenoearcinoma were all based on stage Ⅱ ,the stage Ⅳ was the least,but the stage Ill-iV of gastric gardia adennocareitlnoma was sttglaificantly more than e- sophageal squamous cell carcinoma （P 〈 0.05 ） ; the consistency of tlifferentiation degree, T stage, N stage and clini- cal stage of esophageal squamous cell carcinoma and gastric cardia adenocarcinoma were poor（ the values of Kappa were less than 0.2） ; 3 ） T and N stage werethe indpendent prognostic factors for the patients with concurrent e- sophageal and gastric（cardia） carcinoma （P 〈0.05 ）. Conclusion The rate of missed diagnosis of patients with concurrent esophageal and gastric （cardia） carcinoma is very high; the consistency of two tumors is poor; the factors of effected survivM are complicated.