下咽癌共病食管癌的高危因素及预后分析

目的 探讨下咽癌共病同时性食管癌的高危因素及预后。 方法 2011年1月至2014年3月诊治的200例下咽癌患者作为研究对象,回顾性分析患者的一般资料、肿瘤信息和随访情况。先对可能影响下咽癌共病同时性食管癌的危险因素进行单因素分析,组间比较采用卡方检验,进一步将有统计学差异的因素纳入Logistic回归分析。生存率的分析采用Kaplan-Meier法。 结果 单因素分析发现,年龄(<55岁)、男性、重度吸烟史、重度饮酒史和肿瘤侵犯部位≥3个是下咽癌患者共病同时性食管癌的高危因素(P<0.05)。多因素分析结果显示,年龄(<55岁)、重度吸烟史、重度饮酒史和肿瘤侵犯部位≥3个是下咽癌患者共病同时性食管癌的独立危险因素(P<0.05)。200例下咽癌患者中位生存时间仅为37.5个月,5年生存率仅为36.7%。56例下咽癌共病同时性食管癌患者中位生存时间为24.8个月,低于下咽癌不伴同时性食管癌患者(P<0.05)。早期食管癌(0+Ⅰ期)患者的中位生存时间为29.2个月,明显高于进展期食管癌(Ⅱ+Ⅲ期)的15.8个月,差异有统计学意义(P<0.05)。 结论 下咽癌共病同时性食管癌患者的生存时间较低。年龄(<55岁)、重度吸烟史、重度饮酒史和肿瘤侵犯部位≥3个是下咽癌患者共病同时性食管癌的独立危险因素,临床上应该针对这些高危因素进行早期干预。

Risk factors and prognosis of esophageal cancer with hypopharyngeal carcinoma

Objective To investigate the risk factors and prognosis of hypopharyngeal carcinoma patients with esophageal cancer. Methods This study included 200 patients with esophageal cancer in our hospital from January 2011 to March 2014. General data, tumor information, and follow-up of patients were retrospectively analyzed. First, the risk factors of esophageal cancer with hypopharyngeal carcinoma were analyzed by univariate analysis with comparisons between groups using the chi square test(2). Logistic regression analysis was then performed for factors with statistical differences. The Kaplan-Meier method was used to analyze the survival rate. Results Single-factor analysis revealed that age(<55 years), male gender, severe smoking history, severe alcohol consumption history, and >3 tumor invasion sites were high risk factors for comorbidity of esophageal cancer in hypopharyngeal cancer patients(P<0.05). The results of the multifactor analysis showed that age(<55 years), severe smoking history, severe alcohol consumption history, and >3 tumor invasion sites were independent risk factors for comorbidity of hypopharyngeal carcinoma(P<0.05). The median survival time of the 200 hypopharyngeal cancer patients was 37.5 months, and the 5-year survival rate was 36.7%. The median survival time of 56 patients with concurrent hypopharyngeal carcinoma and concurrent esophageal cancer was 24.8 months, which was significantly lower than that in patients with hypopharyngeal carcinoma without concurrent esophageal cancer(P<0.05). The median survival time in patients with early-stage esophageal carcinoma(0+Ⅰ stage)was 29.2 months, which was significantly higher than that in patients with advanced esophageal carcinoma(Ⅱ+Ⅲ stage), and the difference was statistically significant(P<0.05). Conclusion The survival time in hypopharyngeal cancer patients with concurrent esophageal cancer is relatively low. Age(<55 years), severe smoking history, severe alcohol consumption history, and >3 tumor invasion sites are independent risk factors for comorbidity of hypopharyngeal cancer, and early interventions should be implemented in clinical practice.