68例下颌牙龈鳞癌预后影响因素分析

Analysis of prognostic factors in lower gingival squamous cell carcinoma

目的 :通过对68例下颌牙龈鳞癌患者的回顾性研究,分析影响下颌牙龈鳞癌预后的因素。方法 :对江苏省口腔医院口腔颌面外科2003—2012年收治的68例下颌牙龈鳞癌患者进行回顾分析,利用SPSS 20.0软件包进行Kaplan-Meier生存分析,计算术后3年、5年的生存率(overall survival rate,OSR);采用单因素Log-rank及多因素Cox回归进行生存分析。结果:68例患者的3年、5年OSR分别为77.2%、72.3%。单因素Log-rank分析结果表明,肿瘤颊、舌侧位置,颈淋巴结转移及术后复发与患者预后显著相关(P<0.05)。多因素Cox回归分析显示,肿瘤颊、舌侧部位,颈淋巴结转移与局部复发是5年生存率的独立预后因素(P<0.05)。结论:在下颌牙龈鳞癌中,肿瘤颊、舌侧位置,局部复发,颈淋巴结阳性与患者预后相关,是影响生存率的重要因素。

PURPOSE： To analyze the factors of affecting prognosis by using retrospective study of 68 cases of squamous cell carcinoma （SCC） of the mandibular gingiva. METHODS： A retrospective study of 68 cases of SCC in the mandibular gingiva were carried out, all cases were from Department of Oral and Maxillofacial Surgery, School of Stomatology, Nanjing Medical University from 2003 to 2012. Kaplan-Meier survival analysis was used to evaluate 3- and 5-year overall survival rate （OSR）, factors of affecting prognosis were analyzed by using univariate Log-rank and multivariate Cox regression survival analysis with SPSS 20.0 software package. RESULTS： Sixty-eight patients were included in the study, the 3- and 5-year OSR were 77.2% and 72.3%. Univariate Log-rank analysis showed that tumor location in the buccal or lingual side, cervical lymph node metastasis and recurrence were significantly related to survival rate （P 〈0.05）. Multivariate Cox regression analysis showed that tumor location in the buccal or lingual side, lymph node metastasis and local recurrence were independent prognostic factors of OSR （P〈0.05）. CONCLUSIONS： In SCC of the mandibular gingiva, tumor location in the buccal or lingual side, cervical lymph node metastasis and recurrence were significantly related to survival rate and were independent prognostic factors of OSR.