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目的 :探讨影响初诊即确诊发生肝和(或)肺转移食管鳞癌患者的预后因素。方法 :回顾性分析了2013年1月—2015年1月由安徽医科大学附属省立医院和安徽省肿瘤医院收治的56例初诊时已确诊发生肝和(或)肺转移的食管鳞癌患者的临床资料,应用Kaplan-Meier法计算总生存(overall survival,OS)时间,log-rank法对影响预后的因素进行单因素分析,COX回归模型对影响预后的因素进行多因素分析。结果 :全组患者中位生存时间为11.8个月。单因素分析结果显示,美国东部协作肿瘤组(Eastern Cooperative Oncology Group,ECOG)体能状况(performance status,PS)评分、脏器转移部位和治疗方法与OS有关(P值均<0.05),而性别、年龄、肿瘤的分化程度、病灶转移数目、有无远处淋巴结(锁骨上淋巴结和腹腔干淋巴结)转移以及癌胚抗原(carcinoembryonic antigen,CEA)的表达水平均与OS无关(P值均>0.05)。多因素分析结果显示,ECOG PS评分和脏器转移部位为影响OS的独立因素。结论 :对于初诊时已发生肝和(或)肺转移食管鳞癌患者中,ECOG PS评分和脏器转移部位是影响远期生存的独立预后因素。
OBJECTIVE: To investigate the prognostic factors that affect the diagnosis of newly diagnosed and diagnosed patients with esophageal squamous cell carcinoma of liver and / or lung. Methods: A retrospective analysis of 56 patients with esophageal squamous cell carcinoma who had been diagnosed with liver and / or lung metastasis at the first visit from January 2013 to January 2015 was performed at the Provincial Hospital of Anhui Medical University and Anhui Provincial Cancer Hospital. The Kaplan-Meier method was used to calculate the overall survival (OS) time. The log-rank method was used to univariate analyze the prognostic factors. COX regression model was used to analyze the prognostic factors. Results: The median survival time of all patients was 11.8 months. Results of univariate analysis showed that the performance status (PS) score, organ metastasis location and treatment method in Eastern Cooperative Oncology Group (ECOG) were related to OS (P <0.05), while gender, Age, tumor differentiation, number of metastases, distant lymph nodes (supraclavicular lymph nodes and peritoneal lymph nodes) and carcinoembryonic antigen (CEA) expression levels had no correlation with OS (P> 0.05) . Multivariate analysis showed that ECOG PS score and organ metastasis were independent factors affecting OS. CONCLUSIONS: ECOG PS score and organ metastasis sites are independent predictors of long-term survival in patients with esophageal squamous cell carcinoma of the liver and / or lung that have been diagnosed at first visit.