【摘要】 目的探讨血清淀粉样蛋白A (SAA)升高对食管癌再程放疗患者预后的影响。方法选取2014年3月至2016年6月间汉中市中心医院收治的行再程放疗治疗的45例局部或区域复发食管癌患者,根据放疗前SAA检测结果分为SAA升高(High-SAA)组20例和SAA降低(Low-SAA)组25例。两组患者均采用加速器6MV-X线、三维适形或调强放疗,比较两组患者的临床疗效、不良反应及预后。结果治疗结束后1月,High-SAA组患者近期有效率为35.0%,Low-SAA组为68.0%,两组比较,差异有统计学意义(2=4.86,P <0.05)。High-SAA组患者1年、2年和3年生存率分别为35.0%、10.0%和0.0%,Low-SAA组分别为44.0%、20.0%和16.0%,两组比较,差异有统计学意义(P <0.05)。随访3年,High-SAA组患者死亡20例,其中局部未控12例(含食管穿孔6例),远处转移5例,其他原因3例。Low-SAA组患者死亡21例,其中局部未控13例(含食管穿孔1例),远处转移6例,其他原因2例,长期存活4例。两组患者死亡原因无明显差异,但食管穿孔概率在HighSAA组明显增加(P <0.05)。结论 SAA升高的食管癌患者行再程放疗治疗,近期疗效差,患者生存率较低,易并发食管穿孔。更多还原

【Abstract】 Objective To study the relationship between serum high amyloid A level and prognosis of esophageal cancer on radiotherapy. Methods From March 2014 to June 2016,45 patients with locally or regionally recurrent esophageal cancer who were diagnosed by pathology at Hanzhong Central Hospital were enrolled. They were classified into a high serum amyloid A group( high-SAA group,20 patients) and a low serum amyloid A group( low-SAA,25 patients) based on the SAA testing. All patients received accelerator 6 MV X-ray,three dimensional conformal or intensity modulated radiotherapy. Therapeutic efficacy,adverse reactions and prognosis were compared between the two groups. Results The short-term efficacy rate was 35. 0% in high-SAA group and 68. 0% in low-SAA group at 1 month after the treatment( P <0. 05). The 1-,2-and 3-year survival rate was 35. 0%,10. 0%,0. 0%,respectively in high-SAA group than 44. 0%,20. 0% and 16. 0%,respectively in low-SAA group( all P < 0. 05). Over 3-year follow-up,20 patients died in the high-SAA group of whom 12 patients died from local uncontrol including 6 patients with esophageal perforation,5 patients died from distant metastases and 3 patients died from other causes.Twenty-one patients died in the low-SAA group of whom 13 patients died from local uncontrol including 1 patient with esophageal perforation died from distant metastases,6 patients died from other causes and 4 patients survived. There was no significant difference in causes of death between the two groups( P > 0. 05).However,the incidence of esophageal perforation increased in the high-SAA group. Conclusion Shortterm effeicacy is poor,survival rate is low,and esophageal perforation is easy to occur in patients with elevated serum amyloid A receiving radiotherapy.更多还原