宁夏回族自治区734例回、汉族食管胃交界部腺癌临床病理特征及预后对比分析

发布时间：2018-03-12 07:40

  本文选题：食管胃交界部腺癌　切入点：少数民族　出处：《宁夏医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的探究734例回汉族食管胃交界部腺癌(adenocarcinoma of eso Phagogastric junction,AEG)患者的临床病理特征及预后相关的影响因素。方法选择2002-01至2012-12于宁夏医科大学总医院住院治疗,经胃镜和病理确诊的734例AEG患者为研究对象,收集整理包括收集整理患者资料包括性别、年龄、民族、体重指数、血型、烟酒嗜好、家族史、手术方式、手术类型、Siewert分型、Borrmann分型、肿瘤大小、组织学分型,肿瘤分化、TNM病理分期、淋巴结清扫数目、放化疗情况、生存状态和死亡时间等指标;输入Excel表格,建立数据库。采用SPSS17.0统计分析回汉族患者间临床病理资料及预后状况差异是否存在统计学意义,并对AEG预后相关因素进行单因素、多因素生存分析。结果(1)734例AEG手术患者中,回族患者169例,占23.0%,年龄范围44-78岁,平均年龄61.4±7.4岁;汉族565例,占77.0%,年龄范围33-86岁,平均年61.1±8.9岁。(2)回汉族间吸烟史分布差异有统计学意义(χ~2=43.305,P0.001);回汉族间AEG患者有饮酒史者分布差异有统计学意义(χ~2=49.612,P0.001)。回汉族AEG患者间手术方式、手术类型、Siewert分型、Bormann分型差异无统计学意义(χ~2=2.797,P=0.424;χ~2=0.290,P=0.865;χ~2=3.945,P=0.267);回汉族AEG患者间组织学类型、分化程度、TNM分期分布差异无统计学意义(χ~2=2.714,P=0.257;χ~2=3.911,P=0.141;χ~2=1.697,P=0.638);回汉族AEG患者间行辅助治疗者分布差异无统计学意义(χ~2=1.725,P=0.189)。(3)265例随访AEG患者(36.1%),回族AEG术后患者,平均随访时间为38.4个月,5年总生存率是54.3%;汉族AEG术后患者,平均随访时间为46.4个月;5年总生存率是39.9%。单因素分析显示:年龄、性别、饮酒史、手术类型、Bormann分型、肿瘤大小、肿瘤分化、病理T分期、N分期、M分期等因素(P0.05)是影响AEG预后的主要因素。多因素分析显示:年龄(p=0.005)、性别(p=0.015)、病理T分期(p=0.056),N分期(p0.001),M分期(p0.001),清扫淋巴结数目(p=0.003),辅助放化疗(p=0.005)是影响AEG预后的独立危险因素。结论(1)回汉族AEG患者皆好发于老年男性、有吸烟饮酒史者,病理类型以低分化腺癌多见,TNM分期IV期多见。(2)回族患者中吸烟、饮酒人数明显少于汉族患者,合理健康的生活方式以及早诊早治是预防AEG发生以及改善预后的有效途径。(3)AEG的预后较差,年龄、性别、病理T分期、N分期、M分期、清扫淋巴结数目、辅助放化疗,7个因素是影响AEG预后的独立危险因素。
[Abstract]:Objective to investigate the clinicopathological characteristics and prognostic factors of 734 patients with adenocarcinoma of eso Phagogastric junctions (AEGG) in the esophagogastric junction of Han nationality. Methods from January 2002 to December 2012, the patients were hospitalized in the General Hospital of Ningxia Medical University. A total of 734 patients with AEG diagnosed by gastroscopy and pathology were included in the study. Data of the patients were collected, including sex, age, nationality, body mass index, blood type, tobacco and alcohol addiction, family history, operation methods. Siewert type: Borrmann classification, tumor size, histological classification, pathological stage of tumor differentiation, number of lymph nodes dissection, radiotherapy and chemotherapy, survival status and time of death, etc. To establish the database. To analyze the difference of clinicopathological data and prognosis status between Han nationality patients by SPSS17.0 statistics, and to analyze the prognostic factors of AEG by single factor and multivariate survival analysis. Results in 734 patients with AEG operation, there were 734 cases of AEG operation. There were 169 Hui patients, accounting for 23.0%, with an average age of 61.4 卤7.4 years, 44-78 years old, 565 cases of Han nationality (77.0%), 33-86 years old, 565 cases of Han nationality. The average age was 61.1 卤8.9 years old. The distribution of smoking history in Hui Han nationality was significantly different (蠂 ~ 2 ~ 2 ~ (2) 3. 305) P 0.001 ~ (-1), and the distribution of AEG patients with drinking history was significant (蠂 ~ (2) ~ (2) ~ (2) ~ (29) ~ (12) P _ (0.001) P ~ (0.001)). There was a significant difference in operation mode among AEG patients in Hui Han nationality. There was no significant difference in the type of operation between the two groups (蠂 ~ 2 / 2 / 2.797 / P ~ (0.424); 蠂 ~ (2 / 2) = 0.290 / P ~ (0.865)); 蠂 ~ (2 +) = 3.945 / P ~ (0.267); the histological types of patients with AEG in Han nationality were as follows:. There was no significant difference in the distribution of TNM stages (蠂 ~ 2 / 2 / 2.714 / P ~ (0.257); 蠂 ~ (2 / 2) = 3.911 / P ~ (0.141)); 蠂 ~ (2 +) = 1.697 / P ~ (0.638); there was no significant difference in the distribution of patients receiving adjuvant therapy among the patients with AEG in Han nationality (蠂 ~ (21) 725 P ~ (0.189)). 3265 cases of AEG patients were followed up after AEG operation, and there was no significant difference between them (蠂 ~ (21.725) P _ (0.189)). The average follow-up time was 38.4 months, the 5-year overall survival rate was 54.3, the average follow-up time was 46.4 months in the Han patients after AEG, and the 5-year overall survival rate was 39.9. Univariate analysis showed: age, sex, history of drinking, type of operation, Bormann classification, tumor size. Tumor differentiation, Multivariate analysis showed that age and age were 0.005, sex was 0.015, pathological T stage was p0.0056 / M stage, lymph node number was p0.003, adjuvant radiotherapy and chemotherapy were associated with P0.001, p0.001, p0.001, p0.003, and p0.005) were the main factors influencing the prognosis of AEG. The results of multivariate analysis showed that age was 0.005%, sex was 0.015%, pathological T stage was p0.001 / M stage, lymph node number was p0.003%, and adjuvant radiotherapy and chemotherapy were associated with P0.005). Conclusion the patients with AEG in Han nationality are more likely to occur in elderly men. Among the patients with smoking and drinking history, low differentiated adenocarcinoma was the most common type. TNM stage IV was more common in Hui nationality patients, and the number of drinkers was significantly lower than that of Han nationality patients. A reasonable and healthy lifestyle and early diagnosis and treatment were effective ways to prevent AEG and improve prognosis. The prognosis of AEG was poor. Age, sex, pathological T stage, N stage and M stage, number of lymph nodes dissected. In adjuvant radiotherapy and chemotherapy, 7 factors were independent risk factors for the prognosis of AEG.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735
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本文编号：1600622