高血压与非吸烟非饮酒女性口腔癌的预后研究

Association between hypertension and oral cancer prognosis in non-smoking and non-drinking women

目的探究高血压与非吸烟非饮酒女性口腔癌患者预后的关联。方法2010年9月至2018年1月于福建医科大学附属第一医院口腔颌面外科收集非吸烟非饮酒女性口腔癌病例362例,并开展随访。将患者分为高血压组与非高血压组,运用Kaplan-Meier法计算累积生存率,绘制生存曲线并用log-rank法检验组间差异,采用Cox比例回归模型探讨预后影响因素。运用1∶1倾向性评分匹配得到新的分组,验证上述步骤。分层探讨不同治疗方式与鱼类摄入量下高血压患者与非高血压患者的口腔癌预后情况。结果Cox比例风险模型显示高血压患者的死亡风险是非高血压患者的1.976倍(95%CI 1.003~3.890),首诊淋巴结转移患者的死亡风险是未转移患者的2.938倍(95%CI 1.318~6.551),手术结合辅助治疗的发病风险是单纯手术治疗的0.454倍(95%CI 0.236~0.875),经倾向性评分匹配后,Cox比例风险模型显示高血压患者的死亡风险是非高血压患者的2.987倍(95%CI 1.050~8.497)。分层分析结果显示非高血压患者手术结合辅助治疗的死亡风险是单纯手术患者的0.233倍(95%CI 0.085~0.643),摄入鱼类≥3次/周高血压患者死亡风险是摄入鱼类<3次/周女性口腔癌患者的0.020倍(95%CI 0.001~0.392)。结论高血压是非吸烟非饮酒女性口腔癌患者的独立预后影响因素。非高血压患者手术结合辅助治疗可以降低死亡风险,鱼类摄入量增加对高血压女性口腔癌患者预后具有改善作用。

OBJECTIVE To explore the association between hypertension and prognosis of oral cancer patients in non-smoking and non-drinking women.METHODS From September 2010 to February 2019,362 non-smoking and non-drinking female patients with pathologically confirmed oral cancer were recruited and followed up in the First Affiliated Hospital of Fujian Medical University.The patients were divided into hypertension group and non-hypertensive group,and the Kaplan-Meier method was performed to calculate the cumulative survival rate.The survival curve was tested by the log-rank method for differences between the two groups.Cox proportional regression model was utilized to explore the prognostic factors.1∶1 propensity score matching was applied in order to verify the above findings.Stratified analysis was used to explore the prognosis of oral cancer treated by different method and fish intake between two groups respectively.RESULTS The Cox proportional hazards model showed that the risk of death of hypertension patients was 1.976 times than nonhypertensive patients(95%CI 1.003-3.890),the risk of death for patients with lymph node metastasis was 2.938 times than patients without metastasis(95%CI 1.318-6.551),the risk of death for patients underwent surgery combined with adjuvant therapy was 0.454 times than surgery alone(95%CI 0.236-0.875).After propensity score matching,the Cox proportional hazard model showed that the risk of death for patients with hypertension was 2.987 times than non-hypertensive patients(95%CI 1.050-8.497).The result of stratified analysis showed that the risk of death for non-hypertensive patients with surgery combined with adjuvant therapy was 0.233 times than patients with surgery alone(95%CI 0.085-0.643)and the risk of death in patients with hypertension who consumed fish≥3 times/week was 0.020 times higher than that in women with oral cancer who consumed fish<3 times/week(95%CI 0.001-0.392).CONCLUSION Hypertension is an independent prognostic factor for oral cancer in non-smoking and non-drinking women.Non-hypertensive patients underwent surgery combined with adjuvant therapy can reduce the risk of death and the increase of fish intake can improve the prognosis of hypertensive female oral cancer patients.