Prognostic factors for esophageal squamous cell carcinoma--a population-based study in Golestan Province, Iran, a high incidence area.
Prognostic factors for esophageal squamous cell carcinoma--a population-based study in Golestan Province, Iran, a high incidence area.
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DOI：
10.1371/journal.pone.0022152
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发表时间：
2011
期刊：
影响因子：
3.7
通讯作者：
Malekzadeh R
中科院分区：
文献类型：
--
作者：
Aghcheli K;Marjani HA;Nasrollahzadeh D;Islami F;Shakeri R;Sotoudeh M;Abedi-Ardekani B;Ghavamnasiri MR;Razaei E;Khalilipour E;Mohtashami S;Makhdoomi Y;Rajabzadeh R;Merat S;Sotoudehmanesh R;Semnani S;Malekzadeh R
伊朗北部的Golestan省是食管鳞状细胞癌（ESCC）的高发地区。我们的目的是研究ESCC的预后因素和Golestan病例的生存，这方面的数据很少。我们在一项基于人群的病例对照研究中随访了426例ESCC病例。采用Kaplan-Meier法和Cox比例风险模型对数据进行分析。中位生存期为7个月。诊断年龄与生存率呈负相关，但随着治疗调整，这种相关性消失。居住在城市地区（风险比，HR = 0.70; 95% CI 0.54-0.90）和非土库曼民族（HR = 0.76; 95% CI 0.61-0.96）与较好的预后相关。与其他类型的烟草使用相比，咀嚼nass（一种无烟烟草产品）与预后稍差相关，即使在调整了其他因素（包括疾病阶段和治疗）的模型中也是如此（HR = 1.38; 95% CI 0.99-1.92）。在原始分析中，鸦片使用与较差的预后有关，但在调整后的模型中没有。几乎所有可能治愈的治疗方法都与更长的生存期有关。ESCC在Golestan的预后很差。更容易获得治疗设施可能会改善哥斯达黎加ESCC的预后。观察到的咀嚼牧草与不良预后之间的关系需要进一步研究；这种关联可能表明，摄入非物质成分可能在ESCC的预后中起作用。
Golestan Province in northern Iran is an area with a high incidence of esophageal squamous cell carcinoma (ESCC). We aimed to investigate prognostic factors for ESCC and survival of cases in Golestan, on which little data were available. We followed-up 426 ESCC cases participating in a population-based case-control study. Data were analyzed using the Kaplan–Meier method and the Cox proportional hazard models. Median survival was 7 months. Age at diagnosis was inversely associated with survival, but the association was disappeared with adjustment for treatment. Residing in urban areas (hazard ratio, HR = 0.70; 95% CI 0.54–0.90) and being of non-Turkmen ethnic groups (HR = 0.76; 95% CI 0.61–0.96) were associated with better prognosis. In contrast to other types of tobacco use, nass (a smokeless tobacco product) chewing was associated with a slightly poorer prognosis even in models adjusted for other factors including stage of disease and treatment (HR = 1.38; 95% CI 0.99–1.92). Opium use was associated with poorer prognosis in crude analyses but not in adjusted models. Almost all of potentially curative treatments were associated with longer survival. Prognosis of ESCC in Golestan is very poor. Easier access to treatment facilities may improve the prognosis of ESCC in Golestan. The observed association between nass chewing and poorer prognosis needs further investigations; this association may suggest a possible role for ingestion of nass constituents in prognosis of ESCC.
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