山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (4): 82-86.doi: 10.6040/j.issn.1673-3770.0.2018.234

• 论著 • 上一篇    下一篇

下咽癌共病食管癌的高危因素及预后分析

黄河,欧阳晖   

  1. 四川省内江市第一人民医院耳鼻咽喉头颈外科, 四川 内江 641000
  • 出版日期:2019-07-20 发布日期:2019-07-22

Risk factors and prognosis of esophageal cancer with hypopharyngeal carcinoma

HUANG He, OUYANG Hui   

  1. Department of Otorhinolaryngology Head and Neck Surgery, the First People′s Hospital of Neijiang City, Neijiang 610041, Sichuang, China
  • Online:2019-07-20 Published:2019-07-22

PDF (PC)

490

摘要： 目的 探讨下咽癌共病同时性食管癌的高危因素及预后。 方法 2011年1月至2014年3月诊治的200例下咽癌患者作为研究对象,回顾性分析患者的一般资料、肿瘤信息和随访情况。先对可能影响下咽癌共病同时性食管癌的危险因素进行单因素分析,组间比较采用卡方检验,进一步将有统计学差异的因素纳入Logistic回归分析。生存率的分析采用Kaplan-Meier法。 结果 单因素分析发现,年龄(<55岁)、男性、重度吸烟史、重度饮酒史和肿瘤侵犯部位≥3个是下咽癌患者共病同时性食管癌的高危因素(P<0.05)。多因素分析结果显示,年龄(<55岁)、重度吸烟史、重度饮酒史和肿瘤侵犯部位≥3个是下咽癌患者共病同时性食管癌的独立危险因素(P<0.05)。200例下咽癌患者中位生存时间仅为37.5个月,5年生存率仅为36.7%。56例下咽癌共病同时性食管癌患者中位生存时间为24.8个月,低于下咽癌不伴同时性食管癌患者(P<0.05)。早期食管癌(0+Ⅰ期)患者的中位生存时间为29.2个月,明显高于进展期食管癌(Ⅱ+Ⅲ期)的15.8个月,差异有统计学意义(P<0.05)。 结论 下咽癌共病同时性食管癌患者的生存时间较低。年龄(<55岁)、重度吸烟史、重度饮酒史和肿瘤侵犯部位≥3个是下咽癌患者共病同时性食管癌的独立危险因素,临床上应该针对这些高危因素进行早期干预。

关键词: 下咽癌, 食管癌, 预后, 危险因素

Abstract: Objective To investigate the risk factors and prognosis of hypopharyngeal carcinoma patients with esophageal cancer. Methods This study included 200 patients with esophageal cancer in our hospital from January 2011 to March 2014. General data, tumor information, and follow-up of patients were retrospectively analyzed. First, the risk factors of esophageal cancer with hypopharyngeal carcinoma were analyzed by univariate analysis with comparisons between groups using the chi square test(2). Logistic regression analysis was then performed for factors with statistical differences. The Kaplan-Meier method was used to analyze the survival rate. Results Single-factor analysis revealed that age(<55 years), male gender, severe smoking history, severe alcohol consumption history, and >3 tumor invasion sites were high risk factors for comorbidity of esophageal cancer in hypopharyngeal cancer patients(P<0.05). The results of the multifactor analysis showed that age(<55 years), severe smoking history, severe alcohol consumption history, and >3 tumor invasion sites were independent risk factors for comorbidity of hypopharyngeal carcinoma(P<0.05). The median survival time of the 200 hypopharyngeal cancer patients was 37.5 months, and the 5-year survival rate was 36.7%. The median survival time of 56 patients with concurrent hypopharyngeal carcinoma and concurrent esophageal cancer was 24.8 months, which was significantly lower than that in patients with hypopharyngeal carcinoma without concurrent esophageal cancer(P<0.05). The median survival time in patients with early-stage esophageal carcinoma(0+Ⅰ stage)was 29.2 months, which was significantly higher than that in patients with advanced esophageal carcinoma(Ⅱ+Ⅲ stage), and the difference was statistically significant(P<0.05). Conclusion The survival time in hypopharyngeal cancer patients with concurrent esophageal cancer is relatively low. Age(<55 years), severe smoking history, severe alcohol consumption history, and >3 tumor invasion sites are independent risk factors for comorbidity of hypopharyngeal cancer, and early interventions should be implemented in clinical practice.

Key words: Hypopharyngeal carcinoma, Esophageal cancer, Prognosis, Risk factors

中图分类号: 

  • R739.6
[1] Rodrigo JP, Grilli G, Shah JP, et al. Selective neck dissection in surgically treated head and neck squamous cell carcinoma patients with a clinically positive neck: Systematic review[J]. Eur J Surg Oncol, 2018, 44(4): 395-403. doi:10.1016/j.ejso.2018.01.003.
[2] Osumi H, Yoshio T, Chin K, et al. Chemotherapy is effective for stage I gastric cancer in patients with synchronous esophageal cancer[J]. Gastric Cancer, 2016, 19(2): 625-630. doi:10.1007/s10120-015-0517-9.
[3] Lee KD, Lu CH, Chen PT, et al. The incidence and risk of developing a second primary esophageal cancer in patients with oral and pharyngeal carcinoma: a population-based study in Taiwan over a 25 year period[J]. BMC Cancer, 2009, 9: 373. doi:10.1186/1471-2407-9-373.
[4] Muto M, Nakane M, Katada C, et al. Squamous cell carcinoma in situ at oropharyngeal and hypopharyngeal mucosal sites[J]. Cancer, 2004, 101(6): 1375-1381. doi:10.1002/cncr.20482.
[5] Zhang QL, Zhao LG, Li HL, et al.The joint effects of major lifestyle factors on colorectal cancer risk among Chinese men: A prospective cohort study[J]. Int J Cancer,2018,142(6):1093-1101. doi: 10.1002/ijc.31126.
[6] 黄根牙,马兴刚,王昌成. 重度饮酒与HBV相关肝癌危险性的关系[J]. 中华肿瘤防治杂志, 2005, 12(6): 405-408. doi:10.3969/j.issn.1673-5269.2005.06.002. HUANG Genya,MA Xinggang,WANG Changcheng. Heavy alcohol consumption can enhance risk of hepatocellular carcinoma associated with hepatitis B virus infection[J]. Chinese Journal of Cancer Prevention and Treatment, 2005, 12(6): 405-408. doi:10.3969/j.issn.1673-5269.2005.06.002.
[7] 徐伟,吕正华,杨哲,等. 149例下咽癌手术及术后放射治疗的预后分析[J]. 中华耳鼻咽喉头颈外科杂志, 2014, 49(7): 533-538. doi:10.3760/cma.j.issn.1673-0860.2014.07.002. XU Wei, LÜ Zhenghua, YANG Zhe, et al. Prognostic factors affecting results of comprehensive treatment of hypopharyngeal carcinoma[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery[J] , 2014, 49(7): 533-538. doi:10.3760/cma.j.issn.1673-0860.2014.07.002.
[8] Chen XM, Wang JF, Wang R, et al. Th1-, Th2-, and Th17-associated cytokine expression in hypopharyngeal carcinoma and clinical significance[J]. Eur Arch Otorhinolaryngol, 2016, 273(2): 431-438. doi:10.1007/s00405-015-3779-2.
[9] 白文文,宋玉芝,刘明,等. SIB-IMRT技术在颈及胸上段食管癌中的临床应用[J]. 中华肿瘤防治杂志, 2016, 23(4): 248-252. doi:10.16073/j.cnki.cjcpt.2016.04.010. BAI Wenwen, SONG Yuzhi, LIU Ming, et al. Clinical application of simultaneous integrated boost intensity-modulated radiation therapy in cervical and upper esophageal carcinoma[J].Chinese Journal of Cancer Prevention and Treatment, 2016, 23(4): 248-252. doi:10.16073/j.cnki.cjcpt.2016.04.010.
[10] 郑浩,汪灏,唐汉,等. 新辅助同步放化疗与新辅助化疗治疗局部进展期食管鳞癌的疗效分析[J]. 中华消化外科杂志, 2017, 16(5): 464-468. doi:10.3760/cma.j.issn.1673-9752.2017.05.006. ZHENG Hao, WANG Hao, TANG Han, et al. Effect analysis of neoadjuvant chemoradiotherapy and neoadjuvant chemotherapy in the treatment of locally advanced esophageal squamous cell carcinoma[J]. Chinese Journal of Digestive Surgery, 2017, 16(5): 464-468. doi:10.3760/cma.j.issn.1673-9752.2017.05.006.
[11] Li B, Xu WW, Han L, et al. MicroRNA-377 suppresses initiation and progression of esophageal cancer by inhibiting CD133 and VEGF[J]. Oncogene, 2017, 36(28): 3986-4000. doi:10.1038/onc.2017.29.
[12] Deng XF, Liu QX, Hou B, et al. Esophageal cancer with a synchronous multiple carcinoid of the duodenal bulb[J]. Indian J Surg, 2015, 77(6): 543-544. doi:10.1007/s12262-015-1338-0.
[13] Lo OS, Law S, Wei WI, et al. Esophageal cancers with synchronous or antecedent head and neck cancers: a more formidable challenge?[J]. Ann Surg Oncol, 2008, 15(6): 1750-1756. doi:10.1245/s10434-008-9860-y.
[14] Lee DH, Roh JL, Baek S, et al. Second cancer incidence, risk factor, and specific mortality in head and neck squamous cell carcinoma[J]. Otolaryngol Head Neck Surg, 2013, 149(4): 579-586. doi:10.1177/0194599813496373.
[15] 李思涵,陈智琴,李光. 30例头颈部鳞癌合并同时性食管癌患者疗后临床分析[J]. 中华放射肿瘤学杂志, 2017, 26(7): 728-731. doi:10.3760/cma.j.issn.1004-4221.2017.07.002. LI Sihan,CHEN Zhiqin,LI Guang,et al. A clinical analysis of 30 patients with synchronous head and neck and esophageal cancer[J]. Chinese Journal of Radiation Oncology, 2017, 26(7): 728-731. doi:10.3760/cma.j.issn.1004-4221.2017.07.002.
[16] Haguenoer JM, Cordier S, Morel C, et al. Occupational risk factors for upper respiratory tract and upper digestive tract cancers[J]. Br J Ind Med, 1990, 47(6): 380-383. doi:10.1136/oem.47.6.380.
[17] Lim H, Kim DH, Jung HY, et al. Clinical significance of early detection of esophageal cancer in patients with head and neck cancer[J]. Gut Liver, 2015, 9(2): 159-165. doi:10.5009/gnl13401.
[18] Katsoulakis E, Riaz N, Hu M, et al. Hypopharyngeal squamous cell carcinoma: Three-dimensional or Intensity-modulated radiotherapy? A single institutions experience[J]. The Laryngoscope, 2016, 126(3): 620-626. doi:10.1002/lary.25509.
[19] Visser E, Franken IA, Brosens LA, et al. Prognostic gene expression profiling in esophageal cancer: a systematic review[J]. Oncotarget, 2017, 8(3): 5566-5577. doi:10.18632/oncotarget.13328.
[1] 崔晓波. 诱导化疗在局部晚期下咽癌治疗中的意义[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 10-17.
[2] 黄泽雷,宋琦,路秀英,崔兰珍,李晓明. 双氢青蒿素对下咽癌Fadu细胞内质网应激途径的作用[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 31-35.
[3] 赵青,周涵,殷敏,冯剑,张佳程,刘雅琴,沈宇杰,林子萍,董伟达. 鼻咽纤维血管瘤术前超选择性血管栓塞的应用价值[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 100-105.
[4] 陈慧君,宋圣花,周涵,董伟达,乔明哲,陈曦,徐进,林子萍,邢光前. 血小板与淋巴细胞比值对喉癌复发的预测价值[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 106-110.
[5] 郎永耀,杨云,刘晴,徐林弟,林子萍. 咽喉反流性疾病的影响因素及治疗效果分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 119-123.
[6] 张佳程,张立庆,周涵,陆美萍,许万云,沈宇杰,刘雅琴,殷敏,董伟达. 鼻腔鼻窦恶性黑色素瘤23例临床分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 95-99.
[7] 姜秀颖,李元彬. 后房型人工晶体脱位的临床分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 105-110.
[8] 刘传合. 我国儿童哮喘患病与诊治现状[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 28-32.
[9] 崔乐,关凯,李丽莎,李俊达,王子熹,徐迎阳,王良录,尹佳. 蜜蜂研究人群中蜂毒过敏患病率及相关危险因素分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 63-66.
[10] 黄志刚. CO2激光手术治疗咽喉部肿瘤[J]. 山东大学耳鼻喉眼学报, 2018, 32(6): 1-3.
[11] 沈翎,林宗通,林兴,杨中婕. 儿童阻塞性睡眠呼吸暂停低通气综合征危险因素的[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 25-29.
[12] 刘晓静,王愿,张立庆,冯剑,赵青,宋圣花,周涵,董伟达. 鼻窦骨纤维异常增殖症36例临床分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 73-78.
[13] 吕丹,李明霞,马兰枝,张馨元,肖浩,陈飞,刘均,李珍. 累及纵膈的头颈部丛状I型神经纤维瘤病两例[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 82-86.
[14] 马荣峰,朱富高,孙美红,付涛,张晓恒,曹琳. 突发性聋预后的相关因素分析及疗程选择[J]. 山东大学耳鼻喉眼学报, 2016, 30(4): 69-74.
[15] 谢朝峰,林宏浩. 慢性鼻-鼻窦炎手术预后的临床影响因素分析[J]. 山东大学耳鼻喉眼学报, 2016, 30(4): 90-93.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] 杨长亮,黄治物,姚行齐,诸勇,孙艺 . 正常气骨导听性脑干反应及其应用[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 9 -13 .
[2] 曹忠良 . 颌面复合伤155例临床分析[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 89 -89 .
[3] 毕景云 . 鼻中隔矫正术后血肿的处理[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 90 -91 .
[4] 刘大昱,潘新良,雷大鹏,许风雷,张立强,栾信庸 . 梨状窝内侧壁癌的手术治疗[J]. 山东大学耳鼻喉眼学报, 2007, 21(1): 8 -11 .
[5] 刘 艳,刘新义,王金平,李大健 . 后鼓室解剖结构测量观察及临床意义[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 218 -221 .
[6] 赵 敏,王守森,甄泽年,陈贤明,王茂鑫 . 鼻内镜联合显微镜行蝶窦及经蝶鞍区微创手术[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 244 -245 .
[7] 伦 杰,吕心红 . 鼻部脂溢性角化病1例[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 252 -252 .
[8] 王红霞,王鹏程 . NSE、S100及GFAP在视网膜母细胞瘤中的表达及意义[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 263 -264 .
[9] 黄 方,黄海琼,黄建强,何荷蕃 . 支气管内镜视频监视系统在小儿气管-支气管异物诊治中的应用[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 276 -277 .
[10] 于志良,王卫卫,王明华 . 耳鼻喉综合动力系统切除会厌囊肿23例[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 278 -279 .
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发