舌鳞状细胞癌预后因素的探讨

Investigation of the Tongue Squamous Cell Carcinoma Prognostic Factors

目的 :探讨影响舌鳞癌预后的有效因素。方法 :对 12 1例舌鳞癌患者进行回顾研究 ,应用Cox比例风险模型对 13个与舌鳞癌术后生存率有关的指标进行回归分析。结果 :只有原发灶的切缘状态和颈淋巴结转移情况才是影响舌鳞癌术后生存率的独立指标 (P <0 0 5 )。结论 :对原发灶和颈转移淋巴组织的彻底手术切除是提高舌鳞癌患者生存率的关键。

Objective:The aim of this study was to investigate the factors which influence the prognosis of the tongue squamous cell carcinoma (TSCC).Methods:The Cox's proportional hazard model was used to analyze l2l cases of TSCC treated by the affiliated dental hospital of West China University of Medical Sciences in the period from l990 to 1994. Thirteen parameters (age, sex, occupation, primary tumor site, clinical stage, tumor differentiation, clinical therapy, cervical lymph node metastasis, surgical margin status of the primary tumor, amount of blood transfusion, smoking, drinking, reconstruction during operation) were evaluated. Results:The monofactor analysis showed that factors influencing the postoperative survival of TSCC included primary tumor site, the surgical margin status of the primary tumor and the cervical lymph node metastasis (P<0.05). Multifactor analysis demonstrated that two of these thirteen relevant factors influenced the postoperative survival of TSCC independently. They are successively the surgical margin status of the primary tumor and the cervical lymph node metastasis (P<0.05). Conclusion:This study suggests that it is critical for surgeons to resect the primary tumor and the metastatic cervical lymph nodes thoroughly to improve the survival rate of TSCC patients.