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目的探讨食管神经内分泌癌的临床特征及预后影响因素。方法回顾性分析2008年3月至2014年3月间江苏省南京医科大学第一附属医院胸外科收治的41例食管神经内分泌癌患者的临床资料,其中男37例、女4例,年龄40~79(61.1±7.9岁)岁。本组41例患者全部行手术切除,并行淋巴结清扫。结果全部41例患者围手术期未发生严重并发症,住院期间无死亡。术后接受化疗+放疗13例,单纯化疗11例,单纯放疗1例,剩余16例术后未做特殊治疗。患者随访6~61(24.0±13.6)个月,41例患者中22例存活,19例死亡。1、2、3、4、5年生存率分别为80.49%、39.02%、21.95%、7.32%、4.88%。接受单一手术治疗和术后综合治疗的中位生存时间分别为12.0个月和25.0个月,差异有统计学意义(P<0.05)。T_2~T_4期和T_1期的中位生存时间分别为20.0个月和37.5个月,差异有统计学意义(P<0.05)。Cox回归分析显示,肿瘤浸润深度、术后辅助化放疗是影响患者预后的独立因素(P<0.05)。结论食管神经内分泌癌少见,恶性程度高,外科手术与术后综合治疗相结合有望提高其远期生存率。
Objective To investigate the clinical features and prognostic factors of esophageal neuroendocrine carcinoma. Methods The clinical data of 41 patients with esophageal neuroendocrine carcinoma who underwent thoracic surgery at the First Affiliated Hospital of Nanjing Medical University from March 2008 to March 2014 were retrospectively analyzed. There were 37 males and 4 females, aged 40 ~ 79 (61.1 ± 7.9 years) years old. The group of 41 patients underwent surgical resection, parallel lymph node dissection. Results All 41 patients had no serious complications during perioperative period and no death during hospitalization. Postoperative chemotherapy + radiotherapy in 13 cases, chemotherapy alone in 11 cases, radiotherapy alone in 1 case, the remaining 16 cases did not make special treatment. The patients were followed up for 6 to 61 (24.0 ± 13.6) months. Twenty-two of 41 patients survived and 19 died. The survival rates at 1, 2, 3, 4 and 5 years were 80.49%, 39.02%, 21.95%, 7.32% and 4.88% respectively. The median survival time after single surgery and postoperative comprehensive treatment was 12.0 months and 25.0 months, respectively, with significant difference (P <0.05). The median survival time of T 2 ~ T 4 and T 1 were 20.0 months and 37.5 months, respectively, with significant difference (P <0.05). Cox regression analysis showed that the depth of tumor invasion and postoperative adjuvant radiotherapy were independent prognostic factors (P <0.05). Conclusions Esophageal neuroendocrine carcinoma is rare and has a high degree of malignancy. The combination of surgery and postoperative comprehensive treatment is expected to improve its long-term survival rate.