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目的探讨不同年龄段食管癌患者临床病理特点以及生存状况的差异。方法 426例食管癌患者根据患者的年龄进行分组,>45岁的患者作为中老年组(356例),≤45岁的患者作为分为青年组(70例)。收集患者的临床资料,分析其临床病理特点以及预后。结果所有患者的5年和10年生存率分别为35.2%(150/426)和26.3%(112/426),青年组和中老年组的5年生存率(37.1%vs.34.8%,P>0.05)、10年生存率(30.0%vs.25.6%,P>0.05)差异无显著差异。但青年组患者TNM分期的III期人数比例(51.4%,36/70)高于中老年组(36.5%,130/356),χ2=5.469,P<0.05。Kaplan-Meier法单因素分析,患者淋巴结无转移、淋巴结转移区域数少、分化程度高的食管癌患者预后较好(P<0.05)。Cox回归分析,淋巴结转移(χ2=8.110,P<0.05)、淋巴结转移区域数(χ2=9.992,P=0.002)、分化程度(χ2=4.468,P<0.05)是食管癌患者预后的影响因素。结论虽然青年患者食管癌的病理分期较晚,但其预后与中老年患者无明显差异,淋巴结转移、淋巴结转移区域越多、分化程度低不利于食管癌患者的预后。
Objective To investigate the clinicopathological characteristics and survival of esophageal cancer patients of different ages. Methods 426 patients with esophageal cancer were grouped according to the age of the patients. Patients aged> 45 years were enrolled as middle-aged and elderly patients (356 cases) and patients ≤45 years as young adults (70 cases). The clinical data of patients were collected and their clinicopathological features and prognosis were analyzed. Results The 5-year and 10-year survival rates of all patients were 35.2% (150/426) and 26.3% (112/426), respectively. The 5-year survival rates of young patients and middle-aged patients (37.1% vs.34.8%, P> 0. 05), 10-year survival rate (30.0% vs.25.6%, P> 0.05) no significant difference. However, the proportion of TNM stage III patients in youth group (51.4%, 36/70) was higher than that in middle-aged and elderly patients (36.5%, 130/356) (χ2 = 5.469, P <0.05). Kaplan-Meier method of univariate analysis, patients with lymph node metastasis, lymph node metastasis few, high degree of differentiation of esophageal cancer patients with good prognosis (P <0.05). Cox regression analysis showed that lymph node metastasis (χ2 = 8.110, P <0.05), lymph node metastasis number (χ2 = 9.992, P = 0.002) and differentiation degree (χ2 = 4.468, P <0.05) were prognostic factors for esophageal cancer. Conclusions Although the pathological stage of esophageal cancer is relatively late in young patients, its prognosis is not significantly different from those in middle-aged and elderly patients. The more lymph node metastasis and lymph node metastasis area, the lower the differentiation is not conducive to the prognosis of patients with esophageal cancer.