35例局限期原发食管小细胞癌治疗疗效与预后分析.docVIP

35例局限期原发食管小细胞癌治疗疗效与预后分析 　　[摘要] 目的 分析局限期食管小?胞癌的治疗疗效及预后。 方法 回顾性分析2009年1月1日～2016年6月30日期间收治的局限期食管小细胞癌， 生存率分析采用 Kaplan-Meier 方法，组间生存率比较用Log-Rank 检验，预后因素采用 Cox 回归分析。结果 全组中位生存时间为27.74个月，1年、2年、3年及5年生存率分别为74.28%（26/35）、48.57%（17/35）、28.57%（10/35）及8.57%（3/35）。单因素分析显示，淋巴结阴性者中位存活时间明显高于淋巴结阳性者（36个月vs 20个月，P=0.012）；多因素分析显示，淋巴结转移是独立的不良预后因素。结论 淋巴结阳性是局限期食管小细胞癌的独立预后因素，手术联合化疗、手术联合放化疗以及放化疗三种治疗模式疗效无明显差别。 　　[关键词] 食管肿瘤；小细胞癌；治疗；预后 　　[中图分类号] R735.1 [文献标识码] B [文章编号] 1673-9701（2017）31-0068-04 　　[Abstract] Objective To analyze the therapeutic effect and prognosis of esophageal small cell carcinoma at limited stage. Methods The patients with esophageal small cell carcinoma who were admitted to our hospital from January 1， 2009 to June 30， 2016 were retrospectively analyzed. Kaplan-Meier method was used for survival analysis. Log-Rank test was used for the comparison of survival rate between the two groups. Cox regression analysis was used for prognostic factors. Results The median survival was 27.74 months， 1 year， 2 years， 3 years and 5 years respectively in all groups， and the survival rates were 74.28% （26/35）， 48.57% （17/35）， 28.57% （10/35） and 8.57% （3/35） respectively. Univariate analysis showed that the median survival time of lymph node negative patients was significantly higher than that in lymph node positive patients （36 months vs 20 months， P=0.012）； multivariate analysis showed that lymph node metastasis was independent poor prognostic factors. Conclusion Positive lymph node is an independent prognostic factor for esophageal small cell carcinoma at limited stage. The efficacy of the three treatment methods of surgery combined with chemotherapy， surgery combined with radiotherapy and chemotherapy and chemotherapy combined with radiotherapy have no significant difference. 　　[Key words] Esophageal tumor； Small cell cancer； Treatment； Prognosis 　　原发性食管小细胞癌（primary esophageal small cell carcinoma，PESC）是一种较为罕见的食管恶性肿瘤，国内报道发病率占同期食管恶性肿瘤的0.05%～2.40%[1]，虽然已有较多关于PESC的研究报道，但因该病发病率低，多为小样本回