婚姻状态对颊黏膜鳞癌患者生存的影响

Prognostic impacts of marital status on patients with buccal mucosa squamous cell carcinoma

目的探究婚姻状态对颊黏膜鳞癌患者生存的影响,为颊黏膜鳞癌患者的风险评估和护理决策提供科学依据。方法从美国国立癌症研究所“监测、流行病学和结果”(surveillance,epidemiology,and end re⁃sults,SEER)数据库筛选到颊黏膜鳞癌患者1006例。采用Kaplan⁃Meier分析评估婚姻状态(已婚、未婚和不良婚姻)对颊黏膜鳞癌患者生存的影响,并通过单因素和多因素COX比例风险回归分析进一步确定婚姻状态的独立预后作用。结果婚姻状态是影响颊黏膜鳞癌患者生存的独立危险因素(P=0.001),其中,已婚患者的生存最佳,不良婚姻的患者生存最差(HR=1.445,P=0.001),死亡风险最高,未婚患者居中(HR=1.297,P=0.040)。结论婚姻状态是颊黏膜鳞癌患者预后的独立危险因素,未婚和不良婚姻患者的生存均比已婚患者差,提示在护理及临床实践中不但要关注患者传统的肿瘤生物学特征,还需要关注患者的婚姻状态,并更多地关注未婚和不良婚姻患者的预后风险。

Objective To explore the influence of marital status on the survival of patients with buccal mucosa squamous cell carcinoma(BMSCC)and to provide a scientific basis for risk assessment and nursing decisions for these patients.Methods A total of 1006 BMSCC participants were identified in the Surveillance,Epidemiology,and End Results(SEER)database.Kaplan⁃Meier analysis was used to evaluate the effect of marital status(married,unmarried and unhappily married)on the survival of patients with buccal squamous cell carcinoma.The independent prognostic ef⁃fect of marital status was further determined by univariate and multivariate Cox proportional hazard regression analysis.Results Marital status was an independent prognostic factor for BMSCC patients(P=0.001).Married patients had the best survival,while separated/divorced/widowed patients had the worst survival(HR=1.445,P=0.001),and never married patients had an intermediate risk(HR=1.297,P=0.040).Conclusion Marital status was an independent prognostic factor for BMSCC patients.Unmarried and unhappily married patients had worse survival,which suggests that we should pay more attention to patients’marital status,especially unmarried and unhappily married patients.