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食管鳞状细胞癌患者淋巴管侵犯的预后价值

Prognostic value of lymphovascular invasion in patients with esophageal squamous cell carcinoma.

作者信息

Gu Yi-Min, Yang Yu-Shang, Hu Wei-Peng, Wang Wen-Ping, Yuan Yong, Chen Long-Qi

机构信息

Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, China.

出版信息

Ann Transl Med. 2019 Jun;7(12):256. doi: 10.21037/atm.2019.05.23.

Abstract

BACKGROUND

Whether lymphovascular invasion (LVI) in esophageal squamous cell carcinoma (ESCC) should be considered an independent prognostic factor for survival is controversial. The aim of this report was to investigate the prognostic value of LVI for patients with ESCC.

METHODS

Between October 2010 and July 2011, 152 ESCC patients were retrospectively reviewed. All of the patients underwent curative resection as their primary treatment. Clinicopathological features and overall survival (OS) rate were investigated. Kaplan-Meier curves were used to calculate the OS rate, and the prognostic factors were identified by Cox regression model.

RESULTS

Positive LVI was found in 49 (32.2%) patients. Patients with negative LVI had a significantly better 5-year OS rate than those with positive LVI (52.9% 28.8%; P=0.000). The age, T stage, N stage, tumor differentiation, and LVI were demonstrated to be significant prognostic factors for OS through univariate analyses. LVI was confirmed as an independent prognostic factor for OS through multivariate survival analyses. Subgroup analyses revealed that LVI was associated with a decreased OS in node-negative patients, and no significant difference was observed in node-positive cases.

CONCLUSIONS

Our study highlighted that LVI is an independent prognostic factor in patients with resectable ESCC. LVI may facilitate the stratification of patients with poor survival.

摘要

背景

食管鳞状细胞癌(ESCC)中的淋巴管侵犯(LVI)是否应被视为生存的独立预后因素存在争议。本报告的目的是研究LVI对ESCC患者的预后价值。

方法

回顾性分析2010年10月至2011年7月期间的152例ESCC患者。所有患者均接受了根治性切除术作为主要治疗方法。研究了临床病理特征和总生存率(OS)。采用Kaplan-Meier曲线计算OS率,并通过Cox回归模型确定预后因素。

结果

49例(32.2%)患者LVI阳性。LVI阴性患者的5年OS率明显高于LVI阳性患者(52.9%对28.8%;P=0.000)。通过单因素分析,年龄、T分期、N分期、肿瘤分化和LVI被证明是OS的重要预后因素。通过多因素生存分析,LVI被确认为OS的独立预后因素。亚组分析显示,LVI与淋巴结阴性患者的OS降低相关,而在淋巴结阳性病例中未观察到显著差异。

结论

我们的研究强调LVI是可切除ESCC患者的独立预后因素。LVI可能有助于对生存不良患者进行分层。

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