肿瘤预防与治疗2025，Vol.38Issue(8)：671-679,9.DOI:10.3969/j.issn.1674-0904.2025.08.002
神经侵犯和脉管癌栓与新辅助放化疗后食管癌预后的关系:一项多中心回顾性研究
Association of Perineural and Lymphovascular Invasion with Outcomes in Esophageal Cancer Patients Receiving Neoadjuvant Chemoradiotherapy:A Multicenter Retrospective Study
摘要
Abstract
Objective:We aimed to evaluate the prognostic and staging significance of perineural invasion(PNI)and lymphovascular invasion(LVI)in patients with locally advanced esophageal squamous cell carcinoma(LA-ESCC)treated with neoadjuvant chemoradiotherapy(NCRT).Methods:We performed a retrospective analysis of patients with LA-ESCC treated with NCRT at four hospitals between May 2017 and July 2021.The patients were stratified into three groups based on PNI and LVI:Group 0(absence of both factors),Group 1(presence of one factor),and Group 2(presence of both fac-tors).Propensity score matching(PSM)was used to balance baseline characteristics between groups.We employed multi-variable Cox proportional hazards analysis and Kaplan-Meier curves to evaluate patient prognosis.Results:The study includ-ed 908 patients diagnosed with LA-ESCC,among whom 13.9%had PNI and 7.5%had LVI.Treatment failure occurred in 34.0%of patients,predominantly driven by distant metastases.After PSM,the 3-year overall survival(OS)rates were 65.1%in Group 0,52.7%in Group 1,and 23.0%in Group 2.Based on multivariate analyses,risk scores incorporating PNI and LVI were found to be independent predictors of progression-free survival.In the ypT3 subgroup,the OS and PFS of N0 PNI(+)were similar to those of N1 PNI(-)(P>0.05).Similarly,N1 PNI(+)had a prognosis equivalent to that of N2 PNI(-)(P>0.05).Conclusion:Our risk score model serves as an independent prognosticator for LA-ESCC patients.Subgroup analysis suggests potential necessity for N-stage upstaging in PNI(+)patients.关键词
食管癌/新辅助放化疗/神经侵犯/脉管癌栓Key words
Esophageal cancer/Neoadjuvant chemoradiotherapy/Perineural invasion/Lymphovascular invasion分类
医药卫生引用本文复制引用
植顺吉,黄伟,王奇峰,高文燕,胡兵,朱杰,冷雪峰,韩泳涛,彭林,肖泽芬,章文成..神经侵犯和脉管癌栓与新辅助放化疗后食管癌预后的关系:一项多中心回顾性研究[J].肿瘤预防与治疗,2025,38(8):671-679,9.基金项目
四川省科技厅重点研发项目(编号:2023YFQ0055 （）
2023YFS0488) This study was supported by grants from Science and Technology Department of Sichuan Province(No.2023YFQ0055,No.2023YFS0488). （No.2023YFQ0055,No.2023YFS0488）
