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目的探讨食管癌患者神经侵犯(PNI)与其他临床病理指标的相关性及其对预后的影响。方法回顾性分析2010年1月-2015年8月于新疆医科大学附属肿瘤医院收治的1 160例行食管癌手术患者的临床及病理资料。以术后病理有无神经侵犯将患者分为两组,有神经侵犯的患者147例(12.7%),无神经侵犯患者1 013例(87.3%)。通过SPSS 17.0软件分析神经侵犯与各临床病理因素的相关性及对患者生存的影响。结果χ2检验示PNI与肿瘤浸润程度(p T)、区域淋巴结转移数(p N)、分期(AJCC)、肿瘤部位、分化程度、病理类型、大体分型、是否为脉管内瘤栓均相关(P<0.05)。单因素分析发现神经侵犯与患者总生存时间(OS)有关。通过Kaplan-Meier比较两组生存曲线,生存曲线图可见有神经侵犯的患者生存期明显低于无神经侵犯的患者(P=0.003)。结论 PNI与食管癌患者很多临床及病理因素有关,有PNI的患者生存时间缩短,是一种不良预后因素。
Objective To investigate the correlation between neural invasion (PNI) and other clinicopathological parameters in patients with esophageal cancer and its effect on prognosis. Methods The clinical and pathological data of 1 160 esophageal cancer patients who underwent surgery from January 2010 to August 2015 in Cancer Hospital of Xinjiang Medical University were retrospectively analyzed. The patients were divided into two groups according to the pathological presence or absence of nerve invasion. There were 147 cases (12.7%) with neurological invasion and 1 013 cases (87.3%) without neurological invasion. SPSS 17.0 software was used to analyze the correlation between nerve invasion and clinicopathological factors and the impact on patient survival. Results χ2 test showed that the correlation between PNI and tumor invasion (p T), regional lymph node metastasis (p N), stage (AJCC), tumor location, differentiation degree, pathological type, gross type, P <0.05). Univariate analysis found that nerve invasion was associated with overall patient survival (OS). Survival curves were compared between the two groups by Kaplan-Meier. Survival curves showed that patients with neurological invasion had a significantly lower survival than those without neurological invasion (P = 0.003). Conclusion PNI is associated with many clinical and pathological factors in patients with esophageal cancer. Patients with PNI have shorter survival time and are a poor prognostic factor.