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血小板与性别的交互作用对食管鳞癌根治术患者预后的影响

俞凯莉, 林征, 邱模良, 刘双, 谢倩雯, 饶雯清, 陈元美, 林剑波, 胡志坚. 血小板与性别的交互作用对食管鳞癌根治术患者预后的影响[J]. 中华疾病控制杂志, 2022, 26(7): 820-826. doi: 10.16462/j.cnki.zhjbkz.2022.07.013
引用本文: 俞凯莉, 林征, 邱模良, 刘双, 谢倩雯, 饶雯清, 陈元美, 林剑波, 胡志坚. 血小板与性别的交互作用对食管鳞癌根治术患者预后的影响[J]. 中华疾病控制杂志, 2022, 26(7): 820-826. doi: 10.16462/j.cnki.zhjbkz.2022.07.013
YU Kai-li, LIN Zheng, QIU Mo-liang, LIU Shuang, XIE Qian-wen, RAO Wen-qing, CHEN Yuan-mei, LIN Jian-bo, HU Zhi-jian. A study on the interaction effect of platelet count and sex on prognosis in patients with esophageal squamous cell carcinoma after esophagectomy[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2022, 26(7): 820-826. doi: 10.16462/j.cnki.zhjbkz.2022.07.013
Citation: YU Kai-li, LIN Zheng, QIU Mo-liang, LIU Shuang, XIE Qian-wen, RAO Wen-qing, CHEN Yuan-mei, LIN Jian-bo, HU Zhi-jian. A study on the interaction effect of platelet count and sex on prognosis in patients with esophageal squamous cell carcinoma after esophagectomy[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2022, 26(7): 820-826. doi: 10.16462/j.cnki.zhjbkz.2022.07.013

血小板与性别的交互作用对食管鳞癌根治术患者预后的影响

doi: 10.16462/j.cnki.zhjbkz.2022.07.013
基金项目: 

国家重点研发计划 2017YFC0907100

福建省医学创新课题 2018-CX-38

详细信息
    通讯作者:

    胡志坚,E-mail: hzj99955888@126.com

  • 中图分类号: R735.1

A study on the interaction effect of platelet count and sex on prognosis in patients with esophageal squamous cell carcinoma after esophagectomy

Funds: 

National Key Research and Development Program of China 2017YFC0907100

Medical Innovation Project of Fujian Province 2018-CX-38

More Information
  • 摘要:   目的  探讨血小板(platelets, PLT)对食管鳞癌(esophageal squamous cell carcinoma, ESCC)根治术患者预后的影响及其与性别、年龄间的交互作用。  方法  选取2014年2月1日―2018年11月30日582例符合入组标准的ESCC患者进行回顾性分析。Kaplan-Meier法用于绘制生存曲线并行log-rank检验。运用Cox比例风险回归模型进行多因素分析,计算总生存时间(overall survival, OS)、无病生存时间(disease free survival, DFS)的危险系数(hazard ratios, HR)及其95% CI  结果  PLT仅与性别存在交互作用(HR=2.417, 95% CI: 1.150~5.078, P=0.018)。分层分析显示,男性PLT增多组的死亡风险是PLT正常组的1.713倍(HR=1.713, 95% CI: 1.203~2.441, P=0.003);女性PLT增多组与PLT正常组预后差异无统计学意义(HR=0.590, 95% CI: 0.299~1.165, P=0.129)。  结论  PLT与性别对ESCC根治术患者预后的预测存在交互作用,采用PLT预测患者预后时应注意性别的差异。
  • 图  1  PLT分组对不同性别ESCC患者OS的影响Kaplan-Meier生存曲线分析

    注:(a)PLT分组对女性ESCC患者OS的影响;(b)PLT分组对男性ESCC患者OS的影响。

    Figure  1.  Kaplan-Meier survival curve analysis of the effect of PLT grouping on OS in ESCC patients of different genders

    图  2  不同亚群中PLT与预后的关系森林图

    注:P1值对应各变量不同亚组中PLT与预后的关系; P2值对应PLT与各变量之间的一阶交互检验(各模型均经其余变量调整)。

    Figure  2.  Forest plot of the relationship between PLT and prognosis in different subgroups

    图  3  PLT分组对不同性别ESCC患者DFS的影响Kaplan-Meier生存曲线分析

    注:(a)PLT分组对女性ESCC患者DFS的影响;(b)PLT分组对男性ESCC患者DFS的影响。

    Figure  3.  Kaplan-Meier survival curve analysis of the effect of PLT grouping on DFS of ESCC patients of different genders

    表  1  582例ESCC患者临床特征[n(%)]

    Table  1.   Clinical characteristics of 582 cases of ESCC [n(%)]

    变量 合计
    (N=582)
    福建医科大学附属第一医院
    (n=211)
    福建省肿瘤医院
    (n=371)
    χ2 P 变量 合计
    (N=582)
    福建医科大学附属第一医院
    (n=211)
    福建省肿瘤医院
    (n=371)
    χ2 P
    性别 0.830 0.362 TNM分期 2.332 0.312
      女 145(24.9) 48(22.7) 97(26.1)   Ⅰ~Ⅱ 296(50.9) 104(49.3) 192(51.8)
      男 437(75.1) 163(77.3) 274(73.9)   Ⅲ~Ⅳ 275(47.3) 105(49.8) 170(45.8)
    年龄(岁) 0.326 0.568   缺失 11(1.9) 2(0.9) 9(2.4)
       < 60 242(41.6) 91(43.1) 151(40.7) PNI 6.268 0.044
      ≥60 340(58.4) 120(56.9) 220(59.3)   ≤49.9 293(50.3) 103(48.8) 190(51.2)
    肿瘤部位 14.720 0.001   >49.9 286(49.1) 105(49.8) 181(48.8)
      胸上段 72(12.4) 28(13.3) 44(11.9)   缺失 3(0.5) 3(1.4) 0(0.0)
      胸中段 310(53.3) 131(62.1) 179(48.2) PLT(×109/L) 0.227 0.634
      胸下段 200(34.4) 52(24.6) 148(39.9)   100~300 464(79.7) 166(78.7) 298(80.3)
    肿瘤最长径(cm) 0.362 0.834   >300 118(20.3) 45(21.3) 73(19.7)
      ≤4 364(62.5) 129(61.1) 235(63.3) 术后辅助治疗 0.619 0.431
      >4 211(36.3) 79(37.4) 132(35.6)   否 349(60.0) 131(62.1) 218(58.8)
      缺失 7(1.2) 3(1.4) 4(1.1)   是 233(40.0) 80(37.9) 153(41.2)
    下载: 导出CSV

    表  2  PLT与ESCC患者临床特征间的关系[n(%)]

    Table  2.   Association between PLT and clinical characteristics of ESCC patients [n(%)]

    变量 PLT(×109/L) χ2 P 变量 PLT(×109/L) χ2 P
    100~300(n=464) >300(n=118) 100~300(n=464) >300(n=118)
    性别 0.327 0.567 PNI 2.310 0.315
      女 118(25.4) 27(22.9)   ≤49.9 238(51.3) 55(46.6)
      男 346(74.6) 91(77.1)   >49.9 223(48.1) 63(53.4)
    年龄(岁) 0.377 0.539   缺失 3(0.6) 0(0.0)
       < 60 190(40.9) 52(44.1) TNM分期 4.168 0.124
      ≥60 274(59.1) 66(55.9)   Ⅰ~Ⅱ 241(51.9) 55(46.6)
    肿瘤部位 7.791 0.020   Ⅲ~Ⅳ 217(46.8) 58(49.2)
      胸上段 65(14.0) 7(5.9)   缺失 6(1.3) 5(4.2)
      胸中段 249(53.7) 61(51.7) 术后辅助治疗 0.337 0.561
      胸下段 150(32.3) 50(42.2)   否 281(60.6) 68(57.6)
    肿瘤最长径(cm) 26.116 < 0.001   是 183(39.4) 50(42.4)
      ≤4 312(67.2) 52(44.1)
      >4 145(31.3) 66(55.9)
      缺失 7(1.5) 0(0.0)
    下载: 导出CSV
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出版历程
  • 收稿日期:  2021-03-01
  • 修回日期:  2021-08-04
  • 网络出版日期:  2022-07-19
  • 刊出日期:  2022-07-10

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