鼻咽癌远处转移相关因素的探讨

Analysis on Clinical Factors Related to Distant Metastasis of Nasopharyngeal Cacinorma

目的：探索影响鼻咽癌远处转移的相关因素。方法：使用Logistic多元回归模型，对230例鼻咽癌患者的性别、年龄、病程、首发症状、治疗史、颈部肿块及其位置大小、T和N分期等10个变量被纳入统计分析；找出与远处转移的可能有关的因素。结果：本组鼻咽癌患者中具有明显相关性的变量其远处转移危险度(OR值)依次为：颈部敷药(5.023)，颈部手术(3.858)，男性(3.798)，T分期(2.104)，N分期(1.722);在T分期中，T4的OR值为T1的9.3185倍，T3为T1的4.2546倍。N分期中，N3的OR值为N0的5.099倍，N2为N0的2.9624倍。结论：颈部肿块曾敷中草药或手术切检及男性均为鼻咽癌远处转移高危因素；原发灶局部扩散和颈转移越严重，远处转移的危险性也越高。

Objective：The aim of this study was to explore the factors related to distant metastases of nasopharyngeal carcinoma (NPC). Methods：Multiple variable logistic regression was used to search for the potential relationship between distant metastases of NPC and a lot of factors about the NPC patients. Results：The following factors were included into account：sex, age, course of the disease of NPC, symptoms seen in the primary complain, history of clinical treating, the location and size of neck masses, T and N staging of the disease when diagnosed. The odd ratio(OR) values of the following variables with high risk to distant metastases of NPC were 5.023 (applying some of the medicine on neck masses), 3.858 (having been operated on neck), 3.798 (the sex of male ), 2.104 (T stage), and 1.722 (N stage), respectively. Among the OR value of the T stages, the OR value of T4 was 9.3185 times that of T1, and the OR value of T3 was 4.2546 times that of T1. Among the OR values of N stages, the OR value of N3 was 5.099 times that of N0, the OR value of N2 was 2.9624 times that of N0. Conclusion：Such factors as applying some medicine on neck masses, operation on neck masses, and the sex of male, are all the factors with high risk to distant metastases of NPC. The more serious the spread of the primary tumor and the metastases to neck lymph nodes, the higher the risk of distant metastases would be.