应用Cox模型分析影响胸段食管癌切除术预后的因素

目的 分析影响胸段食管癌切除术后患者预知的因素，探讨各因素之间的关系。方法 采用计算机比例风险模型（Cox模型），对影响胸段食管癌三区域淋巴结清除根治术患者预后的临床因素进行分析。结果 预后与肿瘤侵及深度、分化程度、临床分期、淋巴结转移个数及区域数呈正相关，而与年龄呈负相关（P＜0．01）；性别和肿瘤长度与预后无关。淋巴结转移个数与肿瘤分化程度和侵及深度呈正相关，与年龄呈负相关（P＜0．01），而与3年和5年生存率显著相关（P＜0．01）。本组5年生存率为53．7％。结论 胸段食管癌的预后与肿瘤的侵及深度、分化程度、淋巴结转移个数、肿瘤的部位及患者年龄等因素密切相关；胸段食管癌三区域淋巴结清除根治术有效地提高了淋巴结转移阴性和转移较少患者的生存率。

Study on Factors Influencing Prognosis in Patients with Cancer of the Thoracic Esophagus after Resection by Cox Proportional Hazard Model

Objective To study the prognostic factors in patients with cancer of the thoracic esophagus after curative resection. Methods One hundred and five patients with thoracic esophageal carcinoma underwent esophagectomy through right thoracotomy and three field lymphadenectomy. A multivariate analysis of these individual variables was performed using the cumulative survival rate by the computer's Cox proportional hazard model. Results The prognosis of these patients have a significant correlation among depth of invasion, cell differentiation of tumor, clinical stage, the number of lymph node metastases and the number of district with lymph node metastases, but it has a significant opposite correlation with the age of patients ( P <0 01). There wasn't correlation with sex of patients and length of tumor. The number of lymph node metastases have a significant correlation among cell differentiation of tumor and depth of invasion, and has a opposite correlation with the age of patients ( P <0 01), furthermore, it has a significant correlation with 3 years and 5 years survival rate ( P <0 01). Conclusion The prognostic factors in patients with cancer of the thoracic esophagus have a significant correlation among lymph node metastases,age of the patients,depth of invasion,location of tumor and differentiate of tumor. Three field lymph node dissection does contribute to prolonged survival in patients with no or fewer node metastases.