| Objectives: esophageal cancer(EC) is a common kind of digestive tract malignant tumors,witth a remarkable geographical distribution. EC usually occurs in quinquagenarian people, young patients with esophageal cancer is rare. Its morbidity and mortality is different from one country to another country the Clinical manifestations are basically consisitent, the main performace : discomfort in swallowing,eating pain, hoarseness,chest and back pain,and so on. China is one of the highest incidence and mortality areas for EC in the word..In recent years, the study found that the incidence of a disease has a rising trend.We retrospective analysed 38 youth esophgeal cancer patients’ survival duration of clinical, pathological features and surgical outcomes, etc,comparing with 60 quinquagenarian people in th same period, To explore the clinical features, pathological characteristics of youth esophageal cancer and the influence for the prognosis of esophageal cancer risk.Mothod:Comparing the cinical date of 38 youth esophageal cancer patients with 60 patients collected randomly and treated in the same period,all the date collected at the fourth hospital of hebei medical uiniversity during 2002 to 2009. research group: 19 cases of misdiagnosis, 15 patients with smoking history, 25 cases with history of drinking,9 cases with occasional drinking,8 cases with related family history, 6 cases upper esophageal carcinoma, 18 cases middle esophageal carcinoma,14 cases lower esophageal carcinoma, 30 cases the lesion length less than or equal to 5 cm, 8 cases the lesion length more than 5 cm, Pathology classification 22 cases medulla, 3cases constrictive type, 1cases cavity type, 5 cases fungating type, 7 cases ulerative type. Organization type :36 cases squamous carcinoma, 2cases adenocarcinoma carcinoma. TNM stage 0 1 case, stage I1 cases, stage type II 12 cases,, stage III24 cases. Control group: 2 cases of misdiagnosis, 35 patients with smoking history, 16 cases with history of drinking,10 cases with occasional drinking, 7 cases with related family history, 9 cases upper esophageal carcinoma, 29 cases middle esophageal carcinoma, 22 caseslower esophageal carcinoma, 39 cases the lesion length less than or equal to 5 cm, 11 cases the lesion length more than 5 cm, Pathology classification 31 cases medulla, 5cases constrictive type, 2cases cavity type, 10 cases fungating type, 12 cases ulcerative type, Organization type :54 cases squamous carcinoma, 6cases adenocarcinoma carcinoma. TNM stage 0 2ase, stage I9 ses, stage type II 28 es,, stage III 19 ses.statistical analyses were performed using SPSS 13.0, Contrastive analysis of the two groups between youth esophageal cancer and quinquagenarian esophageal cancer was calculated using theχ2 test,survival curves were calculated using the Kaplan-Meier method,and comparison survival between the curves were analyzed using the log-rank test.Multivariate survival analysis was performed using a Cox proprotional hazards model.A P-value of <0.05 was considered to be statistically significant.Result:1 Comparing youth esophageal cancer with senile esophageal the misdiagnosis rates exist significant difference(P < 0.05). Youth esophageal cancer misdiagnosis rate was higher than control group.2 In the degree of differentiation, the presence of lymph node metastasis, drinking,TNM staging and postoperative survival between the two groups have statistically difference(P < 0.05).Comparing youth esophageal cancer with senile esophageal cancer patients in the clinical pathological characteristics, lesion location, the length of lesion,, smoking, family history have no statistically difference between two groups(P > 0.05).3 The comparison of survival rates between male patients(23cases) and female patients(15 cases) is no statistically significance,the result by Log-Rank test : χ2=1.202,P = 0.273. The comparison of survival rates between family history group(8 cases) and no family history group(30 cases) is no statistically significance, the result by Log-Rank test : χ2=0.021,P= 0.885. The comparison of survival rates between smoking history(15cases) and no smoking history(23 cases) is no statistically significance, the result by Log-Rank test : χ2=1.902,P= 0.168. The comparison of survival rates between drinking history(33cases) and no drinking history(5 cases) has statistically diffrence, the result by Log-Rank test : χ2=16.210,P =0.0001.The comparison of the different lesion locations’ survival rates,including 6 cases upper esophageal carcinoma, 18 cases middle esophageal carcinoma,14 cases lower esophageal carcinoma,is no statistically significance, Log-Rank test : χ2=1.150,P = 0.563. The comparison of survival rates between lymph node metastasis group(28cases) and no Lymph node metastasis group(10 cases) has statistically diffrence, the result by Log-Rank test : χ2=12.815,P= 0.0001. The comparison of the different stages’ survival rates,including stage 0 1case, stage I 1cases, stage type II 12 cases, stage II 24 cases, the result by Log-Rank test : χ2=6054,P= 0.011. The comparison of survival rates between squamous carcinoma group(37cases) and no adenocarcinoma carcinoma group(1 cases) was no statistically significance, the result by Log-Rank test : χ2=2.758,P = 0.097. The comparison of survival rates among the different differentiation degree classification,including poorly differentiated 25 cases, moderately differentiated 9 cases, high differentiation 4 cases,is no satistically significance.the result by Cox proprotional hazards model:(Score test)P =0.0001,(likelihood ratio test) P =0.0001,Two kinds of test methods display model as a whole have statistical significance,the Wald statistical magnitude of drinking ia 5.281,and P =0.022, Show that the variables have an impact on survival time,relative risk is 0.2.Drinking history was identified as independent factors for EC outcome.Conclusion:1 The misdiagnosis rate in youth esophgeal cancer is higher than quinquagenarian cancer people,it is one of the factors that has a impact on the outcome,In clinical,survival rate can be improved if decreasing the misdiagnosis。2 Drinking is a denpendent factor that has a impact on the youth EC outcom,the suvival time of the youth EC who have drinking history is lower.3 differentiation degree has a infulence on the outcome of EC,the suvialrate is lower in poorly differentiated group.4 Lymph node metastasis is a factor tha have a impact on th outcom of EC,the suvival rate of the patients with no lymph node metastasis is higher than the lymph node metastasis group.5 The TNM stages have a impact on the prognosis,the later the stage,the poorer the prognosis.6 Operation is first choice for youth EC,combining radiotherapy or chemotherapy on the basis of postoperation pathlogy efficently improves the youth EC survival rate。... |
PDF Full Text Request