[1]吕 双),宋 昕),赵学科),等.食管鳞癌肿瘤最大长径与浸润深度(T分期)的关系*[J].郑州大学学报(医学版),2017,(05):522-526.[doi:10.13705/j.issn.1671-6825.2017.05.002]
 LYU Shuang),SONG Xin),ZHAO Xueke),et al.Relationship between the maximum tumor length and invasion depth(T Stage)in esophageal squamous cell carcinoma[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2017,(05):522-526.[doi:10.13705/j.issn.1671-6825.2017.05.002]
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食管鳞癌肿瘤最大长径与浸润深度(T分期)的关系*()
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2017年05期
页码:
522-526
栏目:
食管癌研究
出版日期:
2017-09-15

文章信息/Info

Title:
Relationship between the maximum tumor length and invasion depth(T Stage)in esophageal squamous cell carcinoma
作者:
吕 双12)宋 昕1)赵学科1)陈培楠1)范宗民1)胡守佳1)程 让1)杜丹凤1)张向阳1)鲁建亮12)王 苒1)周福有3)王立东1)#
1)郑州大学第一附属医院河南省食管癌重点开放实验室 郑州 450052 2)新乡医学院基础医学院病理学教研室 河南新乡 453003 3)安阳肿瘤医院胸外科 河南安阳 455000
Author(s):
LYU Shuang12) SONG Xin1) ZHAO Xueke1) CHEN Peinan1) FAN Zongmin1) HU Shoujia1) CHENG Rang1) DU Danfeng1) ZHANG Xiangyang1) LU Jianliang12) WANG Ran1) ZHOU Fuyou3) WANG Lidong1)
1)Henan Key Laboratory for Esophageal Cancer Research, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052 2)Department of Pathology, School of Basic Medical Sciences, Xinxiang,Henan Medical University, Xinxiang,Henan 453003 3)Department of Thoracic Surgery, Anyang Tumor Hospital, Anyang,Henan 455000
关键词:
食管鳞癌 肿瘤最大长径 浸润深度 T分期
Keywords:
esophageal squamous cell carcinoma maximum tumor length depth of infiltration T stage
分类号:
R735.1
DOI:
10.13705/j.issn.1671-6825.2017.05.002
摘要:
目的:探讨食管鳞癌患者肿瘤最大长径(MTL)与浸润深度(T分期)的关系,为准确判断临床T分期及临床治疗方式选择提供依据。方法:21 712例食管鳞癌患者中男性13 009例,女性8 703例。通过对根治术后食管大标本形态测量和镜下观察,记录每例患者MTL和肿瘤浸润程度(T分期)。分析食管鳞癌患者一般临床特征及MTL与T分期的关系,运用SPPS软件的决策树模型决定截点值,采用Spearman秩相关和logistic回归分析MTL和T分期的关系。结果:21 712例食管鳞癌患者MTL为0.2~16.5(4.1±1.7)cm。Spearman秩相关显示MTL与T分期呈正相关(rS=0.355,P<0.001)。取3.9 cm为MTL的截点值,logistic回归分析显示,MTL>3.9 cm的患者,T2+T3期的发生风险比≤3.9 cm组明显上升7.146倍(95%CI=6.449~7.918,P<0.001)。男性患者MTL高于女性患者[(4.2±1.8)cm vs(3.9±1.6)cm,P<0.001]。 Spearman秩相关分析显示男性和女性患者MTL均与T分期呈正相关(男:rS=0.341,P<0.001; 女:rS=0.369,P<0.001)。Logistic回归分析显示:MTL>3.9 cm时,男性和女性T2+T3期的风险均明显升高(男:7.251倍,95%CI=6.343~8.288,P<0.001; 女:7.315倍,95%CI=6.234~8.584,P<0.001)。结论:食管鳞癌MTL与T分期呈正相关,MTL>3.9 cm是灵敏反映T分期严重程度的截点值。
Abstract:
Aim: To characterize the relationship between the maximum tumor length(MTL)and invasion depth(T stage)of esophageal squamous cell carcinoma(ESCC)for clinical T stage classification and precision treatment.Methods: A total of 21 712 cases of ESCC consisted of 13 009 males and 8 703 females. MTL and depth of infiltration(T stage)for each patient were recorded based on surgical specimen measurement and light microscopy observation. The decision tree model based on SPSS software was applied to determine the cut-off point of MTL. Spearman rank correlation and logistic regression were used to analyze the relationship between MTL and T stage.Results: The average MTL for 21 712 ESCC patients was 0.2-16.5(4.1±1.7)cm. Spearman rank correlation analysis indicated a positive correlation between MTL and T stage(rS=0.355, P<0.001). Logistic regression analysis showed that the risk of T2 and T3 increased 7.146 times in the patients with a cut-off value of MTL>3.9 cm(95%CI=6.449-7.918, P<0.001). The average MTL in male patients was higher than that in females[(4.2±1.8)cm vs(3.9±1.6)cm,P<0.001]. An apparent positive correlation of MTL and T stage was observed both in males(rS=0.341, P<0.001)and females(rS=0.369, P<0.001). Logistic regression analysis indicated that the risk of T2 and T3 increased at the cut-off value of MTL>3.9 cm both in males and females(male:7.251 times, 95%CI=6.343-8.288, P<0.001; female:7.315 times, 95%CI=6.234-8.584, P<0.001).Conclusion: The present study demonstrates a positive correlation between MTL and T stage in ESCC. MTL>3.9 cm is a sensitive cut-off point to reflect the severity of T stage.

参考文献/References:

[1] 何健,王杰军,钱建新,等.第6版和第7版UICC-AJCC TNM分期预测食管癌根治性切除术后生存情况的比较:基于400例食管癌患者的临床分析[J].肿瘤,2013,33(2):164
[2] 周思思,严苏,陈卫昌,等.超声内镜对早期食管癌术前分期准确性的Meta分析[J].世界华人消化杂志,2014,22(7):988
[3] 王军,祝淑钗,韩春,等.CT扫描食管造影和内窥镜测量食管癌病变长度的价值[J].中国肿瘤临床,2008,35(17):967
[4] JEGANATHAN R,MCGUIGAN J,CAMPBELL F,et al.Does pre-operative estimation of oesophageal tumour metabolic length using 18F-fluorodeoxyglucose PET/CT images compare with surgical pathology length?[J].Eur J Nucl Med Mol Imaging,2011,38(4):656
[5] 申秋,王立东,常扶保,等.食管癌和贲门癌手术切除标本离体前后及固定后的收缩变化[J].郑州大学学报(医学版),2009,44(1):37
[6] GAUR P,SEPESI B,HOFSTETTER WL,et al.Endoscopic esophageal tumor length[J].Cancer,2011,117(1):63
[7] WU N,PANG LW,CHEN ZM,et al.Tumour length is an independent prognostic factor of esophageal squamous cell carcinomas[J].Chin Med J,2012,125(24):4445
[8] FENG JF,HUANG Y,ZHAO Q.Tumor length in elderly patients with esophageal squamous cell carcinoma: is it a prognostic factor?[J].Ups J Med Sci,2013,118(3):145
[9] WANG BY,LIU CY,LIN CH,et al.Endoscopic tumor length is an Independent prognostic factor in esophageal squamous cell carcinoma[J].Ann Surg Oncol,2012,19(7):2149
[10]邵明雯,陈亮,李红霞,等.病变长度对淋巴结阴性食管癌患者的临床病理及预后影响[J].中国癌症杂志,2014,24(11):846
[11]THOMPSON WM.Esophageal cancer[J].Int J Radiat Oncol Biol Phys,1983,9(10):1533
[12]SOBIN LH,HERMANEK P,HUTTER RV.TNM classification of malignant tumors:a comparison between the new(1987)and the old editions[J].Cancer,1988,61(11):2310
[13]WU J,CHEN QX.Prognostic and predictive significance of tumor length in patients with esophageal squamous cell carcinoma undergoing radical resection[J].BMC Cancer,2016,16(394):394
[14]MA MQ,YU ZT,TANG P,et al.Is tumor length a prognostic indicator for esophageal squamous cell carcinoma? A single larger study among Chinese patients[J].Int J Clin Exp Pathol,2015,8(5):5008
[15]YENDAMURI S,SWISHER SG,CORREA AM,et al.Esophageal tumor length is independently associated with long-term survival[J].Cancer,2009,115(3):508
[16]TACHIBANA M,KINUGASA S,DHAR DK,et al.Prognostic factors after extended esophagectomy for squamous cell carcinoma of the thoracic esophagus[J].J Surg Oncol,1999,72(2):88
[17]BOLLSCHWEILER E,BALDUS SE,SCHRÖDER W,et al.Staging of esophageal carcinoma:length of tumor and number of involved regional lymph nodes. Are these independent prognostic factors?[J].J Surg Oncol,2006,94(5):355
[18]陈砚凝,刘月平,张玲玲,等.食管鳞状细胞癌预后的多因素分析[J].中华肿瘤防治杂志,2013,20(14):1094

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备注/Memo

备注/Memo:
*国家自然科学基金委员会和广东省联合重大项目资助 U1301227; 河南省科技重大专项资助 161100311300
#通信作者,男,1958年8月生,博士,教授,研究方向:食管/贲门癌变机制与防治,E-mail:ldwang2007@126.com
更新日期/Last Update: 2017-09-20