青年舌鳞状细胞癌

Squamous cell carcinoma of the tongue in young patients

目的探讨青年舌鳞状细胞癌(简称舌癌)的临床病理特征、预后及影响因素。方法对30例45岁以下青年舌癌患者(青年组)与同期71例45岁及以上(中老年组)进行对照研究,分析其临床病理特征、结果及影响预后的因素。结果青年组和中老年组舌癌浸润性生长的比例分别为40.0%和16.9%(P<0.05),临床分期(III～IV期)的比例分别为40.0%和21.1%(P<0.05)。青年舌癌有复发率及淋巴结转移率增高、生存率降低趋势,但无统计学意义(P>0.05)。单因素分析发现肿瘤生长方式、T分级、N分级、临床分期、肿瘤细胞分化、手术切缘和淋巴结转移显著影响两组患者生存率(P<0.01),多因素回归分析发现肿瘤为浸润性生长、临床晚期、手术切缘≤4 mm是影响舌癌生存的危险因素,RR分别为2.472、4.880、3.124。结论两组舌癌患者在临床病理特征及预后方面相似,但青年患者可能有恶性程度增高的趋势。

OBJECTIVE To explore the clinicopathological characteristics,prognosis and prognostic factors of tongue squamous cell carcinoma（SCC）in young patients.METHODS Thirty tongue cancer patients below 45 years included in this study.Other 71 patients older than 45 years were taken as control group.All the clinical,pathological and survival data of patients were collected.Survival analysis was used to demonstrate the relationship between clinicopathological features and survival rates.Cox regression analysis was used to identify the prognostic factors.RESULTS The proportion of tumor invasion growth in young patients and control group was 40% and 16.9% respectively（P0.05）.The proportions of patients in advanced stage were 40% and 21.1% in young group and control group respectively（P0.05）.High risk of local recurrence and poor prognosis were found in young patients compared with control group,but with no statistical difference（P0.05）.Cox univariate analysis showed the risk factors for tongue cancer prognosis contained tumor growth pattern,T stage,N stage,clinical stage,differentiation,surgical margin and lymphnode metastasis（P0.01）.Cox multivariate analysis also revealed that the tumor growth pattern,clinical stage,and surgical margin were prognostic risk factors of tongue cancer.The relative risk（RR）value was 2.472,4.880 and 3.124 respectively.CONCLUSION Clinicopathological characteristics and prognosis were similar in young and other age patients.But young patients show higher malignance which need further study.