咽后淋巴结对鼻咽癌预后影响的研究

Prognostic Significance of Retropharyngeal Lymphadenopathy in Nasopharyngeal Carcinoma

[目的]分析咽后淋巴结转移对鼻咽癌预后的影响。[方法]收集1999年1月至1999年12月间中山大学肿瘤防治中心放疗科收治、经病理证实的初诊鼻咽癌749例并进行分析。[结果]咽后淋巴结的发生率51.5%。单因素分析显示咽后淋巴结对鼻咽癌总生存率及无远处转移生存率的影响有统计学意义(P<0.001)。多因素分析显示咽后淋巴结转移并不是影响鼻咽癌生存率的独立预后因素,但对无远处转移生存率的影响接近有统计学意义(P=0.053)。对于N0患者,咽后淋巴结转移对鼻咽癌总生存率、无远处转移生存率及无局部区域复发生存率的影响均有统计学意义(P值分别为0.007、0.023和0.008)。[结论]基于鼻咽癌增强CT资料,咽后淋巴结转移对鼻咽癌无远处转移生存率可能有影响,是影响无颈部淋巴结转移的鼻咽癌患者的独立预后因素。

[Purpose]To investigate the prognostic value of retropharyngeal lymphadenopathy in nasopharyngeal carcinoma. [Methods]Between January 1999 and December 1999, 749 of cases of untreated metastasis-free NPC patients, histologically diagnosed, presented at the Department of Radiation Oncology, Cancer Center, Sun Yat-sen University. [Results]The incidence of retropharyngeal lymphadenopathy was 51.5%. In univariate analysis, the significant differences in overall survival （OS） and distant metastasis free survival （DMFS） were found between patient with or without retropharyngeal lymphadenopathy（P〈0.001, P〈 0.001,respectively）, however, the present of retropharyngeal lymphadenopathy was not independent predictor for survival in multivariate analysis, marginal significant difference was observed in DMFS （P=0.053）o In NO disease, the present of retropharyngeal lymphadenopathy was significant independent predictor for OS, locoregional relapse-free survival （LRRFS） and DMFS （P=0.007,0.023 and 0.008, respectively）. [Conclusion]Based on the enhanced CT imaging, the retropharyngeal lymphadenopathy had the tendency to affect the DMFS. It was an independent predictor for survival and metastasis in NO disease.