血清载脂蛋白A-1浓度与食管小细胞癌预后的关系研究

发布时间：2018-06-20 05:55

  本文选题：载脂蛋白A-1 + 食管小细胞癌　； 参考：《郑州大学》2017年硕士论文

【摘要】：研究背景及目的:虽然原发性食管小细胞癌的发病率在食管恶性肿瘤中仅占0.6%-2.8%,是食管癌中较为罕见的病理组织学类型,但是食管小细胞癌的恶性程度极高、侵袭性强、在疾病早期易出现远处转移,对放化疗敏感但易出现复发,预后差。目前,关于评估食管小细胞癌预后的临床病理指标并不明确。大量研究发现血清载脂蛋白A-1的浓度与多种恶性肿瘤(如乳腺癌、卵巢癌、大肠癌等)的发生发展及预后相关,但其与食管小细胞癌间的关系尚未得到研究。因此,本课题主要研究食管小细胞癌患者初次治疗前血清载脂蛋白A-1的浓度与其预后间的关系,以期发现新的预后评估因素,完善现存的预后评估模型,从而对食管小细胞癌的预后实现更加全面准确的评估。资料和方法:回顾性收集2012年2月至2016年5月经郑州大学第一附属医院病理科证实的SCEC患者38例。收集所有患者的完整病历资料(年龄、性别、是否吸烟、是否饮酒、病变部位、TNM分期、VALSG分期、治疗方式、血清ApoA-1浓度、确诊日期、死亡日期等)。根据血清ApoA-1的浓度将患者分为a组(ApoA-1≥1.0g/L)18例和b组(ApoA-11.0 g/L)20例。所有数据均采用SPSS21.0统计学软件进行统计分析,应用Fisher精确检验法比较a、b两组患者各临床指标间的差异。患者的生存期按月计算,应用Kaplan—Meier法进行单因素生存分析,采用log-rank法对生存曲线分布的差异进行检验。采用Cox比例风险回归模型研究多因素对生存时间的影响,以P0.05(双侧检验)为差异具有统计学意义。结果:1.Fisher精确检验显示a、b两组患者各临床指标间的差异均没有统计学意义(P0.05)。2.单因素生存分析显示:局限期和广泛期食管小细胞癌患者的中位生存期为19.64月vs 16.87月,a组和b组食管小细胞癌患者的中位生存期为19.64月vs17.08月;局限期和广泛期(21.00±1.03月vs 16.60±0.60月)以及a组和b组(21.05±1.12月vs 16.77±0.74月)食管小细胞癌患者的总生存期间的差异具有统计学意义(P0.05)。3.Cox多因素生存分析显示血清ApoA-1浓度是影响SCEC预后的因素(P=0.021)。结论:血清ApoA-1浓度下降可缩短SCEC的生存时间,是SCEC预后的独立危险因素。
[Abstract]:Background and objective: although the incidence of primary small cell carcinoma of the esophagus is only 0.6- 2.8 percent of esophageal malignant tumors, it is a rare histopathological type of esophageal cancer, but its malignancy is very high and its invasion is strong. Distant metastasis is easy to occur in the early stage of the disease, sensitive to radiotherapy and chemotherapy, but easy to recur, and the prognosis is poor. At present, the clinicopathologic parameters for evaluating the prognosis of small cell carcinoma of esophagus are not clear. A large number of studies have found that the concentration of serum apolipoprotein A-1 is associated with the occurrence, development and prognosis of various malignant tumors (such as breast, ovarian, colorectal cancer, etc.), but the relationship between Apolipoprotein A-1 and esophageal small cell carcinoma has not been studied. Therefore, this study mainly studies the relationship between serum apolipoprotein A-1 concentration and prognosis in patients with small cell carcinoma of esophagus before initial treatment, in order to find new prognostic factors and improve existing prognostic evaluation models. Thus, the prognosis of small cell carcinoma of esophagus can be evaluated more comprehensively and accurately. Materials and methods: from February 2012 to May 2016, 38 patients with SCEC confirmed by Department of Pathology of the first affiliated Hospital of Zhengzhou University were retrospectively collected. The complete medical records of all the patients were collected (age, sex, smoking, drinking, location of lesion and VALSG staging, treatment, serum ApoA-1 concentration, date of diagnosis, date of death, etc.) According to the concentration of serum ApoA-1, the patients were divided into two groups: group a (ApoA-1 鈮，

本文编号：2043217