恶性肿瘤家族史与鼻咽癌预后的关系

Effect of family history of cancer on clinical features and prognostic factors of patients with nasopharyngeal carcinoma

目的:探讨恶性肿瘤家族史与鼻咽癌患者的临床特征及预后的关系。方法:回顾性分析2009年1月至2013年12月汕头大学医学院附属粤北人民医院89例具有恶性肿瘤家族史及388例无恶性肿瘤家族史的鼻咽癌患者临床特征及预后资料。结果:恶性肿瘤家族史组与无恶性肿瘤家族史组鼻咽癌病例相比较,性别、年龄、TNM分期、病理类型、放疗前Hb、放疗方式间差异无统计学意义(P>0.05)。恶性肿瘤家族史组患者3年总生存时间(overall survival,OS)较无恶性肿瘤家族史组长,分别为91.6%、85.5%,两组间差异无统计学意义(P=0.211)。单因素、多因素分析显示,T分期、N分期及TNM分期是鼻咽癌患者OS、无进展生存期(progression-free survival,PFS)、无远处转移生存期(distant metastasis-free survival,DMFS)的重要影响因素(P<0.05)。然而恶性肿瘤家族史及鼻咽癌家族史对鼻咽癌3年OS、PFS、无局部复发生存期(locoregional relapse-free survival,LRFS)、DMFS差异均无统计学意义(P>0.05)。结论:恶性肿瘤家族史鼻咽癌患者3年OS较无恶性肿瘤家族史组长,但两组间差异无统计学意义(P>0.05)。T分期、N分期越晚的鼻咽癌患者预后不佳。恶性肿瘤家族史对鼻咽癌的预后无统计学意义。

Objective： To explore the effect of family history of cancer on clinical features and prognostic factors in nasopharyngeal car- cinoma （NPC） patients. Methods： The clinical data of 89 NPC patients with a family history of cancer and 388 NPC patients without a family history of cancer were retrospectively reviewed. Univariate and multivariate survival analyses were performed to identify possi- ble prognostic factors. Results： The clinical characteristics of NPC patients with and without family history of cancer were compared. The gender, age, TNM stage, pathological type, and hemoglobin radiotherapy concentration before treatment did not significantly dif- fer between the two groups （P〉0.05）. NPC patients with a family history of cancer had better 3-year overall survival than those with- out family history of cancer （92.6% vs. 85.5%）, but no statistically significant difference was observed （P=0.221）. Both univariate and multivariate analyses showed that T, N, and TNM stages were the important prognosis factors affecting 3-year overall survival （OS）, progression free survival （PFS）, and distant metastasis-free survival （DMFS） of NPC （P〈0.05）. However, neither family history of cancer nor family history of NPC in 3-year OS, PFS, LRFS, and DMFS was significant in NPC patients （P〉0.05）. Conclusion： NPC patients with family history of cancer had better 3-year OS than those without family history of cancer, but no statistically significant observation was found. Large T stage or high lymph node stage contributed to poor survival of NPC. Family history of cancer had no significant in- fluence on the survival of NPC patients.