目的:探讨农村和城市地区差异对食管鳞癌患者生存影响。方法:36 723例食管鳞癌患者临床诊疗、病理和随访信息全部取自郑州大学第一附属医院河南省食管癌重点开放实验室50万例食管癌和贲门癌生物样本数据库(1973年至2015年)。农村患者33 625例(91.6%),其中男性20 906例,平均诊断年龄(58.98±8.71)岁;女性12 719例,平均诊断年龄(59.59±8.53)岁;城市患者3 098例(8.4%),其中男性2 089例,平均诊断年龄(60.84±9.10)岁;女性1 009例,平均诊断年龄(62.46±9.14)岁。所有患者均行食管癌根治术治疗,并记录完整病理TNM分期。采用χ~2检验、Kaplan-Meier,Log-rank和多因素Cox风险比例回归模型方法分析各组间差异及生存影响因素。结果:Kaplan-Meier和Log-rank总体分析显示:农村食管癌患者整体生存明显优于城市患者(χ~2=12.971,P<0.001);年龄、性别和TNM分期多因素分层分析显示:农村年龄≥50岁男性和女性Ⅱa、Ⅱb(中期)的患者生存明显优于城市患者(男性:χ~2=16.188,P<0.001;女性:χ~2=5.019,P=0.025);但是,0、Ⅰa、Ⅰb(早期)和Ⅲa、Ⅲc、Ⅳ期(晚期)农村和城市患者生存差异无统计学意义(P>0.05)。Cox比例风险回归模型分析显示:影响农村和城市患者生存的独立危险因素均为年龄、性别和TNM分期;而农村和城市患者综合分析显示:男性、诊断年龄≥50岁、城市和TNM分期是食管鳞癌患者预后差的独立危险因素。结论:农村地区食管癌患者整体生存优于城市患者;男性、诊断年龄≥50岁、城市和TNM分期是食管鳞癌患者预后差的独立危险因素。 Objective: To investigate the impact of rural and urban differences on the survival of patients with esophageal squamous cell carcinoma. Methods: The clinical diagnosis and treatment, pathology and follow-up of 36 723 esophageal squamous cell carcinoma patients were all obtained from the database of 500,000 cases of esophageal and cardiac cancer biological samples in Key Laboratory of Esophageal Cancer of the First Affiliated Hospital of Henan University from 1973 to 2015 ). In rural areas, 33 625 (91.6%) patients were male, including 20 906 males with a mean age at diagnosis of 58.98 ± 8.71 years, 12 719 females with an average age of diagnosis of 59.59 ± 8.53 years, 3 098 urban patients with 8.4% There were 2 089 males with an average diagnosis of 60.84 ± 9.10 years of age and 1 009 females with an average diagnosis of 62.46 ± 9.14 years of age. All patients underwent radical resection of esophageal cancer, and recorded the complete pathological TNM staging. Chi-square test, Kaplan-Meier, Log-rank and multivariate Cox risk proportional regression model were used to analyze the differences among groups and the influencing factors of survival. Results: The overall Kaplan-Meier and Log-rank analysis showed that the overall survival of patients with esophageal cancer in rural areas was significantly better than that of urban patients (χ ~ 2 = 12.971, P <0.001). Multivariate stratification analysis of age, sex and TNM stage showed that: The survival of patients aged ≥50 years in stage Ⅱa and Ⅱb (mid term) was significantly better than that in urban patients (χ ~ 2 = 16.188, P <0.001; χ ~ 2 = 5.019, P = 0.025) There were no significant differences in survival between Ⅰa, Ⅰb (early stage) and Ⅲa, Ⅲc and Ⅳ (late stage) rural and urban patients (P> 0.05). Cox proportional hazards regression model analysis showed that: independent risk factors affecting the survival of rural and urban patients were age, sex and TNM staging; and rural and urban patients comprehensive analysis showed that: male, diagnosis of age ≥ 50 years old, urban and TNM staging esophageal Squamous cell carcinoma patients with poor prognosis of independent risk factors. Conclusion: The overall survival of patients with esophageal cancer is better than that of urban patients in rural areas. In male, the diagnostic age is over 50 years. The urban and TNM stages are the independent risk factors for poor prognosis in patients with esophageal squamous cell carcinoma.