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目的:探讨婚育因素对中国女性食管鳞状细胞癌患者术后生存预后影响.方法:12041例女性食管癌患者信息均来自河南省食管癌重点开放实验室食管癌数据库,患者均经组织病理学证实为食管鳞状细胞癌且有翔实婚育史记录及完整临床病理资料.通过调查问卷、家访、电话问询方式进行患者生存随访.Kaplan-Meier生存曲线及Cox生存分析模型分析不同婚育因素对女性食管鳞癌患者预后影响.结果:校正年龄、职业、吸烟、饮酒、体质量指数和肿瘤病理分期等可能混杂因素后Cox多因素生存分析显示怀孕次数多女性预后较好(RR=1.49,95%CI:1.16-1.92),分层分析发现该生存优势也存在于高发区女性(RR=1.41,95%CI:1.03-1.86)及食管癌家族史阴性女性(RR=1.21,95%CI:1.04-1.41).绝经前期女性预后明显优于围绝经期和绝经后期女性患者(P=0.00),尤其是来自于高发区(RR=0.73,95%CI:0.62-0.86)和家族史阴性绝经前期女性(RR=0.70,95%CI:0.58-0.85).结论:怀孕次数和经期状态可能是中国女性食管鳞癌患者术后预后影响因素,怀孕次数多女性及绝经前期女性患者术后预后较好.
Objective: To investigate the impact of marriage and childbearing factors on the survival and prognosis of esophageal squamous cell carcinoma in Chinese women.Methods: The information of 12041 women with esophageal cancer were from the esophageal cancer esophageal cancer open source laboratory in Henan Province, all patients were histopathologically Confirmed esophageal squamous cell carcinoma and informative marriage history record and complete clinicopathological data.Patients were followed up by questionnaires, home visits, telephone inquiries.Kaplan-Meier survival curve and Cox survival analysis model analysis of different marriage and childbirth factors The prognosis of female patients with esophageal squamous cell carcinoma was analyzed.Results: Cox multivariate survival analysis showed that the prognosis of women with esophageal squamous cell carcinoma was better than that of women with multiple pregnancies (RR = 1.49, (RR = 1.41, 95% CI: 1.03-1.86) and female patients with negative family history of esophageal cancer (RR = 1.21, 95% CI, 95% CI: 1.16-1.92). The survival advantage was also found by stratified analysis. : 1.04-1.41) .The premenopausal women had significantly better prognosis than those in perimenopausal and postmenopausal women (P = 0.00), especially in high incidence areas (RR = 0.73, 95% CI: 0.62-0.86) and family history negative menopause Preterm women (RR = 0.70,95% CI: 0.58-0.85) .Conclusion: The frequency of pregnancy and menstrual status may be the prognostic factors of esophageal squamous cell carcinoma patients in China. The prognosis of women with multiple pregnancies and premenopausal women is more it is good.