【摘要】：目的:探討農(nóng)村和城市地區(qū)差異對(duì)食管鱗癌患者生存影響。方法:36 723例食管鱗癌患者臨床診療、病理和隨訪信息全部取自鄭州大學(xué)第一附屬醫(yī)院河南省食管癌重點(diǎn)開放實(shí)驗(yàn)室50萬例食管癌和賁門癌生物樣本數(shù)據(jù)庫(1973年至2015年)。農(nóng)村患者33 625例(91.6%),其中男性20 906例,平均診斷年齡(58.98±8.71)歲;女性12 719例,平均診斷年齡(59.59±8.53)歲;城市患者3 098例(8.4%),其中男性2 089例,平均診斷年齡(60.84±9.10)歲;女性1 009例,平均診斷年齡(62.46±9.14)歲。所有患者均行食管癌根治術(shù)治療,并記錄完整病理TNM分期。采用χ~2檢驗(yàn)、Kaplan-Meier,Log-rank和多因素Cox風(fēng)險(xiǎn)比例回歸模型方法分析各組間差異及生存影響因素。結(jié)果:Kaplan-Meier和Log-rank總體分析顯示:農(nóng)村食管癌患者整體生存明顯優(yōu)于城市患者(χ~2=12.971,P0.001);年齡、性別和TNM分期多因素分層分析顯示:農(nóng)村年齡≥50歲男性和女性Ⅱa、Ⅱb(中期)的患者生存明顯優(yōu)于城市患者(男性:χ~2=16.188,P0.001;女性:χ~2=5.019,P=0.025);但是,0、Ⅰa、Ⅰb(早期)和Ⅲa、Ⅲc、Ⅳ期(晚期)農(nóng)村和城市患者生存差異無統(tǒng)計(jì)學(xué)意義(P0.05)。Cox比例風(fēng)險(xiǎn)回歸模型分析顯示:影響農(nóng)村和城市患者生存的獨(dú)立危險(xiǎn)因素均為年齡、性別和TNM分期;而農(nóng)村和城市患者綜合分析顯示:男性、診斷年齡≥50歲、城市和TNM分期是食管鱗癌患者預(yù)后差的獨(dú)立危險(xiǎn)因素。結(jié)論:農(nóng)村地區(qū)食管癌患者整體生存優(yōu)于城市患者;男性、診斷年齡≥50歲、城市和TNM分期是食管鱗癌患者預(yù)后差的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective: to investigate the influence of the difference between rural and urban areas on the survival of esophageal squamous cell carcinoma patients. Methods: the clinical diagnosis and treatment of 36 723 patients with esophageal squamous cell carcinoma were studied. All the pathological and follow-up information were obtained from the database of biological samples of 500000 cases of esophageal carcinoma and cardia carcinoma in Henan Provincial key Open Laboratory of esophageal Cancer, the first affiliated Hospital of Zhengzhou University (1973-2015). There were 33,625 (91.6%) patients in rural areas, 20 906 males (mean diagnostic age 58.98 鹵8.71), 12719 females (59.59 鹵8.53) years old. There were 3 098 cases (8.4%) in urban area, of which 2089 cases were male, the average diagnostic age was (60.84 鹵9.10) years old, the average diagnostic age was (62.46 鹵9.14) years old in female 1 009 cases. All patients were treated with radical resection of esophageal carcinoma and complete pathological TNM staging was recorded. 蠂 ~ 2 test, Kaplan-Meier,Log-rank and multivariate Cox risk ratio regression model were used to analyze the differences and survival factors among the groups. Results: Kaplan-Meier and Log-rank analysis showed that the overall survival of rural patients with esophageal cancer was significantly better than that of urban patients (蠂 ~ 2 ~ (12.971) P 0.001). The multivariate stratification analysis of age, sex and TNM stage showed that the patients with rural age 鈮，

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