發(fā)布時(shí)間：2018-06-20 05:55

  本文選題：載脂蛋白A-1 + 食管小細(xì)胞癌��； 參考：《鄭州大學(xué)》2017年碩士論文

【摘要】：研究背景及目的:雖然原發(fā)性食管小細(xì)胞癌的發(fā)病率在食管惡性腫瘤中僅占0.6%-2.8%,是食管癌中較為罕見的病理組織學(xué)類型,但是食管小細(xì)胞癌的惡性程度極高、侵襲性強(qiáng)、在疾病早期易出現(xiàn)遠(yuǎn)處轉(zhuǎn)移,對(duì)放化療敏感但易出現(xiàn)復(fù)發(fā),預(yù)后差。目前,關(guān)于評(píng)估食管小細(xì)胞癌預(yù)后的臨床病理指標(biāo)并不明確。大量研究發(fā)現(xiàn)血清載脂蛋白A-1的濃度與多種惡性腫瘤(如乳腺癌、卵巢癌、大腸癌等)的發(fā)生發(fā)展及預(yù)后相關(guān),但其與食管小細(xì)胞癌間的關(guān)系尚未得到研究。因此,本課題主要研究食管小細(xì)胞癌患者初次治療前血清載脂蛋白A-1的濃度與其預(yù)后間的關(guān)系,以期發(fā)現(xiàn)新的預(yù)后評(píng)估因素,完善現(xiàn)存的預(yù)后評(píng)估模型,從而對(duì)食管小細(xì)胞癌的預(yù)后實(shí)現(xiàn)更加全面準(zhǔn)確的評(píng)估。資料和方法:回顧性收集2012年2月至2016年5月經(jīng)鄭州大學(xué)第一附屬醫(yī)院病理科證實(shí)的SCEC患者38例。收集所有患者的完整病歷資料(年齡、性別、是否吸煙、是否飲酒、病變部位、TNM分期、VALSG分期、治療方式、血清ApoA-1濃度、確診日期、死亡日期等)。根據(jù)血清ApoA-1的濃度將患者分為a組(ApoA-1≥1.0g/L)18例和b組(ApoA-11.0 g/L)20例。所有數(shù)據(jù)均采用SPSS21.0統(tǒng)計(jì)學(xué)軟件進(jìn)行統(tǒng)計(jì)分析,應(yīng)用Fisher精確檢驗(yàn)法比較a、b兩組患者各臨床指標(biāo)間的差異。患者的生存期按月計(jì)算,應(yīng)用Kaplan—Meier法進(jìn)行單因素生存分析,采用log-rank法對(duì)生存曲線分布的差異進(jìn)行檢驗(yàn)。采用Cox比例風(fēng)險(xiǎn)回歸模型研究多因素對(duì)生存時(shí)間的影響,以P0.05(雙側(cè)檢驗(yàn))為差異具有統(tǒng)計(jì)學(xué)意義。結(jié)果:1.Fisher精確檢驗(yàn)顯示a、b兩組患者各臨床指標(biāo)間的差異均沒有統(tǒng)計(jì)學(xué)意義(P0.05)。2.單因素生存分析顯示:局限期和廣泛期食管小細(xì)胞癌患者的中位生存期為19.64月vs 16.87月,a組和b組食管小細(xì)胞癌患者的中位生存期為19.64月vs17.08月;局限期和廣泛期(21.00±1.03月vs 16.60±0.60月)以及a組和b組(21.05±1.12月vs 16.77±0.74月)食管小細(xì)胞癌患者的總生存期間的差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。3.Cox多因素生存分析顯示血清ApoA-1濃度是影響SCEC預(yù)后的因素(P=0.021)。結(jié)論:血清ApoA-1濃度下降可縮短SCEC的生存時(shí)間,是SCEC預(yù)后的獨(dú)立危險(xiǎn)因素。
[Abstract]:Background and objective: although the incidence of primary small cell carcinoma of the esophagus is only 0.6- 2.8 percent of esophageal malignant tumors, it is a rare histopathological type of esophageal cancer, but its malignancy is very high and its invasion is strong. Distant metastasis is easy to occur in the early stage of the disease, sensitive to radiotherapy and chemotherapy, but easy to recur, and the prognosis is poor. At present, the clinicopathologic parameters for evaluating the prognosis of small cell carcinoma of esophagus are not clear. A large number of studies have found that the concentration of serum apolipoprotein A-1 is associated with the occurrence, development and prognosis of various malignant tumors (such as breast, ovarian, colorectal cancer, etc.), but the relationship between Apolipoprotein A-1 and esophageal small cell carcinoma has not been studied. Therefore, this study mainly studies the relationship between serum apolipoprotein A-1 concentration and prognosis in patients with small cell carcinoma of esophagus before initial treatment, in order to find new prognostic factors and improve existing prognostic evaluation models. Thus, the prognosis of small cell carcinoma of esophagus can be evaluated more comprehensively and accurately. Materials and methods: from February 2012 to May 2016, 38 patients with SCEC confirmed by Department of Pathology of the first affiliated Hospital of Zhengzhou University were retrospectively collected. The complete medical records of all the patients were collected (age, sex, smoking, drinking, location of lesion and VALSG staging, treatment, serum ApoA-1 concentration, date of diagnosis, date of death, etc.) According to the concentration of serum ApoA-1, the patients were divided into two groups: group a (ApoA-1 鈮，

本文編號(hào)：2043217