喉鳞状细胞癌71例诊疗分析

Outcome analysis of 71 patients with laryngeal squamous cell carcinoma

目的研究喉鳞状细胞癌预后的相关危险因素。方法回顾性分析2013年1-12月于浙江省肿瘤医院首次诊治的喉鳞状细胞癌患者71例的临床资料。结果单因素分析显示,声门上型与声门型间(60. 0%比 86.3%,χ^2 =6.284,P<0.05),N0 与 N+组间(41.7%比 86.4%,χ^2 = 16. 803 ,P <0. 01)、临床分期早晚期组间(93.6%比50. 0%, χ^2 = 19. 854,P <0.01)生存率差异均有统计学意义;年龄W50岁、> 50 ~60 岁,>60-70 岁、>70 岁组间(8& 9%比 88.2%比 79. 3%比 62. 5%,χ^2 =3.909,P>0.05),T1 +T2 与 T3 +T4组间(83. 6%比62.5%,χ^2 = 3. 623 ,P >0.05),高、中、低分化及未标明组间(75.0%比69.7%比83.3%比91.7%,χ^2 =3. 780, P >0.05),手术、放疗与手术+放疗组间(74. 3%比 90. 9%比 71.4%, χ^2 = 2. 437,P >0.05)生存率差异均无统计学意义。多因素分析显示,年龄(P =0.003)、治疗方式(P=0.048)对患者预后的影响差异有统计学意义;肿瘤位置(P =0. 766)、T分期(P = 0.677)、淋巴结是否转移(P =0. 482)、临床分期(P=0.825)、病理分化程度(P =0.206)对患者预后的影响差异均无统计学意义'结论伴淋巴结转移的中晚期、高龄患者因预后较差,应给予更加积极的治疗,在喉癌的治疗过程中应注重喉功能的保留,提高拔管率。

Objective To investigate the prognosis relevant factors of laryngeal squamous cell carcinoma (LSCC). Methods From January 2013 to December 2013 , the clinical data of 71 patients with LSCC who were initially treated in Zhejiang Cancer Hospital were retrospectively analyzed. Results Univariate analysis showed that there were statistically significant differences in survival rate between the group of supraglottic type and glottic type (60.0% vs. 86. 3%,χ^2 = 6.284,P <0.05),the group of NO and N +(41.7% vs. 86.4%,χ^2 = 16. 803 ,P <0.01), the group of early and late stage(93. 6% vs. 50. 0%,χ^2 = 19. 854,P <0. 01 ). There were no statistically significant differences in survival rate between the group of age W50,>50 - 60,>60 - 70 and > 70( 88. 9% vs. 88. 2% vs. 79. 3% vs. 62. 5%,χ^2 =3. 909 ,P〉0. 05), the group of T1 + T2 and T3 + T4( 83. 6% vs. 62. 5%,=3. 623, P > 0. 05),the group of high, medium, low differentiated and unsigned (75. 0% vs. 69. 7% vs. 83. 3% vs. 91.7%,χ^2= 3. 780,P >0. 05 ), the group of surgery, radiotherapy and surgery + radiotherapy ( 74. 3% vs. 90. 9% vs. 71.4%, χ^2= 2. 437 ,P > 0. 05 ). Multivariate analysis showed that age ( P = 0. 003 ), treatment ( P = 0. 048 ) had significant effect on the prognosis of patients,but tumor location( P = 0. 766),T stage( P = 0. 677),N stage(P =0.482),clinical stage(P =0. 825 ), the degree of pathological differentiation ( P = 0. 206) had no significant effect on the prognosis of patients. Conclusion More aggressive treatment should be supplied for patients with N +, advanced clinical stage and age whom the prognosis are usually poor. In addition, the proportion of tracheal tube extraction should be appreciated.