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

  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。

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

  Objective  To investigate the prognostic value of the preoperative platelet count (PLT) and its interactions with gender and age in patients with esophageal squamous cell carcinoma (ESCC) after esophagectomy.  Methods  A total of 582 patients with ESCC were eligible for retrospective analysis between February 1, 2014, and November 30, 2018. The survival rate was calculated using the Kaplan-Meier method and the comparison of the two groups was performed by using the Log-rank test. Univariate and multivariate analyses were calculated using the Cox proportional hazards regression model to determine prognostic factors associated with overall survival (OS) and disease-free survival(DFS). Hazard ratios (HRs) and (95% CI) were used as common measures to assess relative risk.  Results  PLT only interacted with gender (HR=2.417, 95% CI: 1.150-5.078, P=0.018). Stratified analysis showed that PLT increased group was independently associated with a 71.3% risk increase for death compared with PLT normal group (HR=1.713, 95% CI: 1.203-2.441, P=0.003) in male patients; While in female patients, there was no statistical significance between groups (HR=0.590, 95% CI: 0.299-1.165, P=0.129).  Conclusions  There is an interaction between PLT and gender in predicting the prognosis of patients with ESCC after esophagectomy. Gender differences should be paid attention to when PLT is chosen to be a prognostic factor.