Clinical Characteristics Of Esophageal Carcinoma With Multiple Primary Cancers Of Digestive Tract

Objective: Esophageal cancer is a common malignant tumor of the digestive system.In recent years,the prevalence and mortality of esophageal cancer have increased year by year.Esophageal cancer associated with multiple primary cancers of the digestive system is a relatively rare form of disease in the clinic.Early diagnosis and treatment can significantly improve the prognosis of patients and improve the survival rate of patients.This article aims to analyze the clinical features of multiple primary cancers of esophageal cancer with digestive system,and to explore early prediction methods and related influencing factors of esophageal cancer with multiple primary cancer.Method: Inpatients diagnosed as "esophageal malignant tumor" or "esophageal cancer" were selected from the Affiliated Hospital of Qingdao University from January 2015 to January 2018.Through the analysis of the patient's medical history and examination data,the eligible cases are screened out.According to the inclusion and exclusion criteria,the subjects were divided into a simple esophageal cancer group(hereinafter referred to as a non-multiple primary cancer group)and an esophageal cancer with a digestive system multiple primary cancer group(hereinafter referred to as a multiple primary cancer group).Inclusion criteria: pathological results confirmed as esophageal cancer,auxiliary examination and medical history data are complete.Exclusion criteria: cases without pathological results,the diagnosis is not clear is a case of esophageal cancer,auxiliary examination and medical history data is incomplete.The age,sex,BMI,drinking history,smoking history,family history,primary cancer location,nature,degree of differentiation,multiple primary cancer location,nature,and degree of differentiation were also included in all subjects,and the subjects were recorded for hyperglycemia.Hyperlipidemia,high uric acid,HP infection,tumor metastasis,or surgical treatment.These data were divided into two parts for analysis.The first part was to analyze non-multiple primary cancer groups and multiple primary cancer groups to find the risk factors for multiple primary cancers.The second part is a subgroup analysis of multiple primary cancer groups to find related factors associated with multiple primary cancers at different locations in the digestive system.All statistical data were analyzed by SPSS 20.0 for univariate analysis.The qualitative data were analyzed by X2 test,and the quantitative data were evaluated to conform to the normal distribution.The normal distribution data were subjected to t test,and the non-normal distribution data were subjected to u test.P < 0.05 was considered statistically significant.Through the single factor analysis,find the relative influence factors.Multivariate logistic regression analysis was used to analyze the influencing factors.Results: A total of 1582 cases were retrieved in this study.A total of 1362 patients were included in the study after screening according to inclusion and exclusion criteria.Among them,there were 1214 cases in non-multiple primary cancer groups,and 148 cases in esophageal cancer with multiple primary cancers in the digestive system.The multiple primary cancer group was divided into 45 cases(30.4%)of the hypopharynx,46 cases(31.08%)of the esophagus,45 cases(30.4%)of the stomach,and 12 cases(8.12%)of the intestine.The results were divided into the following two parts: 1.Non-multiple primary cancer group and multiple primary cancer group statistical analysis: Smoking history,smoking index(>400),drinking history,BMI,between the two groups were observed by univariate analysis.There were significant differences in the primary cancer site,the pathological type of primary cancer,and whether or not surgery was performed.The P values were 0.047,0.008,0.009,0.015,0.014,0.007,and <0.001.There were no obvious differences in age,gender,family history,HP infection,hypertension,hyperlipidemia,hyperuricemia,primary cancer differentiation and metastasis between the two groups.Multivariate logistic regression analysis was performed on statistically significant factors,drinking history(OR=1.893,95% CI: 1.002-3.577,p<0.05),primary cancer site(OR=0.746,95% CI: 0.599-0.996,p<0.05),pathological type(OR=1.411,95% CI: 1.032-1.930,p<0.05),whether surgery(OR=0.401,95% CI: 0.262-0.613,p<0.001)is esophageal cancer An independent risk factor for multiple primary cancers.2.Statistical analysis of multiple primary cancers with different sites: by single factor analysis,age(P < 0.001),drinking history(P = 0.007),primary cancer site(P = 0.036),more The primary cancer pathology type(P < 0.001),multiple primary cancer differentiation(P = 0.007),and multiple primary cancer occurrence(P = 0.01)were statistically different between the groups.Logistic regression analysis was performed on the above effective factors.The model was statistically significant,X2=152.893,p=0.000,which correctly classified 87.8% of the subjects.The age of the patient,the location of the primary cancer,the pathological type of multiple primary cancer and the stage of occurrence were significantly correlated among the groups(P<0.05).Conclusion:1.A total of 1362 patients were included in the study,of which 10.87% were patients with multiple primary cancers with digestive system.With the advancement of diagnostic techniques,esophageal cancer with multiple primary cancers of the digestive system has gradually become a more common clinical phenomenon.2.The digestive system associated with multiple primary cancers is more common in the pharynx,esophagus and stomach,and the intestinal tract is slightly less,of which 79.7% are simultaneous multiple primary cancers.In the clinical diagnosis and treatment process,it is necessary to pay attention to the application of various diagnostic methods to improve the detection rate and diagnosis rate of multiple primary cancers.3.History of drinking,primary cancer of the esophagus,pathological type and whether or not surgery is an independent risk factor for esophageal cancer with multiple primary cancers of the digestive system.At the same time,the analysis of each group in multiple primary cancers showed that the age,the location of the primary cancer,the pathological type of multiple primary cancers,and the stage of occurrence were all significantly correlated.