摘要
目的:回顾性分析鼻腔鼻窦腺样囊性癌(ACC)的临床特征及预后差异。方法:搜集2007-2017年收治的鼻腔鼻窦ACC患者67例,重点分析其病例特征、手术方式,并采用寿命表法、Kaplan-Meir法及Cox比例风险模型分别进行生存及复发结局的生存分析。结果:中位生存时间为6.68年,1年、5年、10年生存率分别为95%、79%、67%。单因素分析显示性别、年龄、首发症状至确诊时间、肿瘤位置、临床分期及Ki-67阳性率与鼻腔鼻窦ACC的预后相关,多因素分析显示性别、首发症状至确诊时间、Ki-67阳性率可作为评价鼻腔鼻窦ACC患者预后的独立危险因素。中位复发时间为6.13年,1年、3年、5年复发率分别为5%、7%、9%。性别、首发症状至确诊时间、切缘情况及Ki-67阳性率与鼻腔鼻窦ACC的复发相关,首发症状至确诊时间、切缘情况、Ki-67阳性率可作为评价鼻腔鼻窦ACC患者复发风险的独立危险因素。结论:性别、首发症状至确诊时间、Ki-67阳性率可作为评价鼻腔鼻窦ACC患者预后的指标。首发症状至确诊时间、切缘情况、Ki-67阳性率可作为评价鼻腔鼻窦ACC患者复发风险的指标。首发症状至确诊时间及Ki-67阳性率能同时指示复发且能同时提示复发及死亡风险,因此针对首发症状至确诊时间长及Ki-67阳性率>30%的患者应缩短复查周期。而手术切缘情况对肿瘤复发风险有指示作用,而对患者远期死亡风险并无明显影响,临床医生应重视各项指示预后的指标,针对较差预后患者,缩短复查时间,改善患者预后。
Objective:To investigate the clinical features and prognosis of adenoid cystic carcinoma(ACC)in nasal cavity and sinus.Method:67 patients with ACC were recruited interview in our department from 2007 to2017.The association between clinical parameters and survival were evaluated by statistical analysis.Result:The1-,5-and 10-overall survival were 95%,79%,67%,and the 1-,3-and 5-year recurrence rate were 5%,7%,9%,respectively.Simple factor analysis displays that age,the location of the tumour,clinical stages,sex,the interval time between starting symptoms to diagnosis time,the expression quantity of Ki-67 were related to the prognosis,and the latter three and surgical margin were also influential factors of distant metastasis after treatment.Multi-factors analysis revealed that sex,the interval time between starting symptoms to diagnosis time,the expression quantity of Ki-67 were significant factors for prognosis,and the latter two and surgical margin were influential factors of distant metastasis after treatment.Conclusion:The sex and the interval time between starting symptoms to diagnosis time and Ki-67 may be independent prognostic factors for ACC.The interval time between starting symptoms to diagnosis time and Ki-67 level may be independent factors of distant metastasis after treatment.Patients with long interval time between starting symptoms to diagnosis time and high expression of Ki-67 may have a higher risk of recurrence and mortality,which need reexamination of cycle-time reduction.The surgical margin is influential factor of distant metastasis,but not for the patientsprognosis.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2017年第22期1740-1744,共5页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery