口腔鳞状细胞癌淋巴结转移危险因素的Logistic回归分析

Logistic multivariate regression analysis of risk factors associated with lymph node metastasis in oral squamous cell carcinoma

目的选择常用的临床及病理指标,通过多因素分析,筛选出与口腔鳞癌淋巴结转移密切相关的指标,建立预测方程,为临床预测口腔鳞癌淋巴结转移提供参考。方法选择100例口腔鳞癌患者,记录性别、年龄、发病部位、T分期、N分期、病程等6个临床指标;选择肿瘤细胞浸润深度、浸润方式、淋巴细胞浸润程度、肿瘤的粘附力、基底膜的连续性、血管生成、肿瘤增殖等病理指标,进行Logistic逐步回归分析。结果浸润深度、平均血管密度、VEGF和E-CD染色阳性细胞率具有统计学意义。得出预测方程:P=exp(-6·5689+1·5309XDEPTH+3·8116XMVD+2·8066XVEGF+5·5917XE-CD)/1+exp(-6·5689+1·5309XDEPTH+3·8116XMVD+2·8066XVEGF+5·5917XE-CD)。经回代分析,预测方程的准确性为95%。结论口腔鳞癌细胞的浸润深度、E-CD和VEGF的表达程度、肿瘤血管平均密度是与口腔鳞癌淋巴结转移密切相关的危险因素,通过预测方程得出的概率值可为手术方案的制定提供参考。

Objective To investigate the clinical and pathological predictors for cervical lymph node metastasis in OSCC using muhifactorial analysis method. Methods One hundred patients with OSCC were included in this study. Clinical parameters （ sex, age, primary location, T stages, N stages and course of diseases） and pathological parameters （ depth of invasion, fashion of tumor invasion, grade of pathology, degree of lymph cell invasion, adhesion, continuity of basement member, angiogenesis of tumor and proliferation ） were analyzed by logistic multivariate regression analysis. Results The depth of invasion, the positive rate of VEGF and E-CD expression and MVD were correlated with metastasis, and the forecasting equation was established. Using substitution method, the veracity of the forecasting equation was 95%. Conclusion The depth of invasion, the positive rate of VEGF and E-CD expression and MVD were risk factors associated with lymph node metastasis in OSCC. The probability obtained from the forecasting equation may offer references for making treatment plan.