神经侵犯对食管癌患者预后的影响及放射治疗的意义

发布时间：2018-05-08 20:12

本文选题：食管癌 + 神经侵犯　；参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:探讨食管癌患者存在神经侵犯(Perineural Invasion,PNI)对预后的影响以及辅助放疗对生存时间的影响。方法:回顾性分析新疆医科大学附属肿瘤医院2010年1月至2015年8月期间收治的1160例行食管癌手术患者的临床及病理资料,以术后病理有无神经侵犯将患者分为两组,有神经侵犯的患者147例(12.7%),无神经侵犯患者1013例(87.3%)。通过SPSS 17.0软件分析两组患者之间临床病理因素、生存时间有无差异、以及术后辅助放疗能否改善生存时间。结果:?2检验示两组患者的肿瘤浸润程度(pT)、区域淋巴结转移数(pN)、分期(AJCC)、肿瘤部位、分化程度、病理类型、大体分型、是否有脉管内瘤栓之间有统计学差异(P0.05)。单因素分析发现神经侵犯与患者总生存时间(Overall Survival,OS)、无病生存时间(Disease-free Survival,DFS)均有关,COX多因素分析发现神经侵犯不是影响预后的独立影响因素。通过Kaplan-Meier比较两组生存曲线,生存曲线图可见有神经侵犯的患者OS、DFS明显低于无神经侵犯的患者(P=0.003、0.033),进一步分析有PNI患者行辅助放疗较未行辅助放疗患者的生存时间长。结论:PNI是一种不良预后因素,有PNI的患者总生存时间、无病生存时间均缩短,而术后辅助放疗能明显改善生存时间。
[Abstract]:Objective: to investigate the effect of perineural invading PNII on prognosis and the effect of adjuvant radiotherapy on survival time in patients with esophageal carcinoma. Methods: the clinical and pathological data of 1160 patients with esophageal carcinoma treated in Cancer Hospital of Xinjiang Medical University from January 2010 to August 2015 were retrospectively analyzed. There were 147 patients with nerve invasion and 1013 patients with no nerve invasion. SPSS 17.0 software was used to analyze the clinicopathological factors and survival time of the two groups, and whether postoperative adjuvant radiotherapy could improve the survival time. Results the tumor invasion degree, regional lymph node metastasis, AJCCI, tumor location, differentiation degree, pathological type, gross type, and whether there were intravascular tumor embolus were significantly different between the two groups (P 0.05). Univariate analysis showed that nerve invasion was associated with total survival time (total survival time) and disease-free survival time (DFSs). Cox multivariate analysis showed that nerve invasion was not an independent prognostic factor. By comparing the survival curves of the two groups by Kaplan-Meier, the survival curve showed that the survival curve of patients with nerve invasion was significantly lower than that of patients without nerve invasion. The survival time of patients with PNI undergoing adjuvant radiotherapy was longer than that of patients without adjuvant radiotherapy. Conclusion PNI is a poor prognostic factor. The total survival time and disease-free survival time of the patients with PNI are shortened, while postoperative adjuvant radiotherapy can significantly improve the survival time.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.1

【参考文献】