血清胸苷激酶1对老年早期声门型喉癌行低温等离子射频消融术、CO2激光术和喉裂开术治疗的预后评估价值

Prognostic Value of Serum Thymidine Kinase-1 in Elderly Patients with Early Glottic Carcinoma Treated by Low Temperature Plasma Radiofrequency Ablation,CO2 Laser and Laryngeal Fissure Surgery

目的探究血清胸苷激酶1(thymidine kinase 1,TK1)对老年早期声门型喉癌接受低温等离子射频消融术、CO2激光术和喉裂开术治疗的预后评估价值。方法选取老年早期声门型喉癌患者共180例,随机给予低温等离子射频消融术(n=60)、CO2激光术(n=60)和喉裂开术(n=60)。术前检测患者血清TK1水平,并进行KPS评分。术后1个月对患者进行KPS评分与疗效评估。存活患者均进行5年随访。结果相比于喉裂开术组,低温等离子射频消融术组与CO2激光术组患者的治疗有效率、疾病控制率与KPS评分均显著提高,而死亡率显著降低(P<0.05)。此外,低温等离子射频消融术与CO2激光术对低TK1水平患者的治疗效果优于高TK1水平患者(P<0.05)。生存分析结果表明,相比于喉裂开术组,低温等离子射频消融术组与CO2激光术组患者的5年生存率均显著提高(P<0.05)。低温等离子射频消融术组与CO2激光术组中的低TK1水平患者的5年生存率显著提高(P<0.05)。相比于低TK1组患者,高TK1组患者的5年死亡率约增加32%;相比于喉裂开术,低温等离子射频消融术组与CO2激光术可分别使5年死亡率降低46.5%与47.7%。结论低温等离子射频消融术与CO2激光术对老年早期声门型喉癌的治疗效果优于喉裂开术,且更适用于低TK1水平患者。

Objective To explore the prognostic value of serum thymidine kinase 1(TK1)in elderly patients with early glottic carcinoma treated by low temperature plasma radiofrequency ablation,CO2 laser and laryngeal fissure surgery.Methods A total of 180 elderly patients with early glottic laryngeal cancer were randomly treated with low temperature plasma radiofrequency ablation(n=60),CO2 laser(n=60)and laryngeal fissure(n=60).Serum TK1 level was detected before operation and KPS score was performed.KPS score and curative effect were evaluated 1 month after operation.Survival patients were followed up for 5 years.Results Compared with the laryngeal fissure surgery group,the treatment efficiency,disease control rate and KPS score of the cryogenic low temperature plasma radiofrequency ablation group and the CO2 laser group were significantly improved,while the mortality rate was significantly reduced(P<0.05).The therapeutic effect of low-temperature plasma radiofrequency ablation and CO2 laser on patients with low TK1 level is better than that of patients with high TK1 level(P<0.05).The results of survival analysis showed that compared with laryngeal fissure surgery group,the 5-year survival rate of low temperature cryogenic plasma radiofrequency ablation group and the CO2 laser group were significantly improved(P<0.05).Further analysis showed that the 5-year survival rate of patients with low TK1 level in low temperature plasma radiofrequency ablation group and CO2 laser group were improved most significantly(P<0.05).Compared with the low TK1 group,the 5-year mortality rate of the high TK1 group increased by 32%,and compared with laryngeal fissure surgery,the 5-year mortality rate of the low temperature plasma radiofrequency ablation group and CO2 laser group decreased by 46.5%and 47.7%,respectively.Conclusion Low temperature plasma radiofrequency ablation and CO2 laser are more effective than laryngeal fissure surgery in the treatment of early glottic carcinoma in the elderly,and they are both more suitable for patients with low serum TK1 level.