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目的:探讨食管鳞癌患者肿瘤最大长径(MTL)与浸润深度(T分期)的关系,为准确判断临床T分期及临床治疗方式选择提供依据.方法:21712例食管鳞癌患者中男性13009例,女性8703例.通过对根治术后食管大标本形态测量和镜下观察,记录每例患者MTL和肿瘤浸润程度(T分期).分析食管鳞癌患者一般临床特征及MTL与T分期的关系,运用SPPS软件的决策树模型决定截点值,采用Spearman秩相关和logistic回归分析MTL和T分期的关系.结果:21712例食管鳞癌患者MTL为0.2~16.5(4.1±1.7)cm.Spearman秩相关显示MTL与T分期呈正相关(rS=0.355,P3.9 cm的患者,T2+T3期的发生风险比≤3.9 cm组明显上升7.146倍(95%CI=6.449~7.918,P<0.001).男性患者MTL高于女性患者[(4.2±1.8)cm vs(3.9±1.6)cm,P<0.001].Spearman秩相关分析显示男性和女性患者MTL均与T分期呈正相关(男:rS=0.341,P<0.001;女:rS=0.369,P3.9 cm时,男性和女性T2+T3期的风险均明显升高(男:7.251倍,95%CI=6.343~8.288,P<0.001;女:7.315倍,95%CI=6.234~8.584,P3.9 cm是灵敏反映T分期严重程度的截点值.“,”Aim:To characterize the relationship between the maximum tumor length ( MTL) and invasion depth ( T stage) of esophageal squamous cell carcinoma (ESCC) for clinical T stage classification and precision treatment .Methods:A total of 21712 cases of ESCC consisted of 13009 males and 8703 females.MTL and depth of infiltration(T stage) for each patient were recorded based on surgical specimen measurement and light microscopy observation .The decision tree model based on SPSS software was applied to determine the cut-off point of MTL .Spearman rank correlation and logistic re-gression were used to analyze the relationship between MTL and T stage. Re sults:The average MTL for 21712 ESCC pa-tients was 0.2-16.5(4.1 ±1.7) cm.Spearman rank correlation analysis indicated a positive correlation between MTL and T stage (rS =0.355, P3.9 cm(95%CI=6.449-7.918, P<0.001).The average MTL in male pa-tients was higher than that in females [(4.2 ±1.8) cm vs (3.9 ±1.6) cm,P<0.001].An apparent positive correlation of MTL and T stage was observed both in males (rS =0.341, P<0.001) and females(rS =0.369, P3.9 cm both in males and fe-males(male:7.251 times, 95%CI=6.343-8.288, P<0.001;female:7.315 times, 95%CI=6.234-8.584, P3.9 cm is a sensitive cut-off point to reflect the severity of T stage .