早期舌鳞状细胞癌患者术后预后的影响因素分析

Influencing factors of postoperative prognosis in patients with early tongue squamous cell carcinoma

目的探讨早期舌鳞状细胞癌患者术后预后的影响因素。方法收集90例接受手术治疗的早期舌鳞状细胞癌患者的病历资料,所有患者术后随访3年,统计患者的生存情况。采用Cox比例风险回归模型分析早期舌鳞状细胞癌患者预后的影响因素。结果90例早期舌鳞状细胞癌患者随访3年未出现失访病例,病死率为27.78%(25/90),3年生存率为72.22%(65/90)。不同性别、吸烟情况、饮酒情况、肿瘤部位、肿瘤类型、临床T分期、颈部淋巴结清扫情况、术后化疗情况的早期舌鳞状细胞癌患者的3年生存率比较,差异均无统计学意义(P﹥0.05);不同年龄、组织分化程度、肿瘤复发情况、颈部淋巴结转移情况、术后放疗情况的早期舌鳞状细胞癌患者的3年生存率比较,差异均有统计学意义(P﹤0.05)。Cox多因素回归分析结果显示,年龄≥60岁、低分化、肿瘤复发、颈部淋巴结转移及术后未放疗均是早期舌鳞状细胞癌患者预后的独立危险因素(P﹤0.05)。结论早期舌鳞状细胞癌患者术后预后的影响因素较多,临床可根据具体影响因素进行针对性改善,重视术后复发、转移监测和辅助治疗,降低患者术后复发、转移风险,进而改善其预后。

Objective To explore the influencing factors of postoperative prognosis in patients with early tongue squamous cell carcinoma.Method The medical data of 90 patients with early tongue squamous cell carcinoma was collected and all patients were followed up for 3 years.The survival was analyzed and the prognostic factors of early tongue squamous cell carcinoma were analyzed by using Cox proportional hazard model.Result There was no loss of followup in the 90 cases;the fatality rate was 27.78%(25/90),and the 3-year survival rate was 72.22%(65/90).There was no significant difference in 3-year survival rate among patients with different gender,smoking,drinking,tumor location,tumor type,clinical T stage,cervical lymph node dissection and postoperative chemotherapy(P>0.05).There were significant differences in 3-year survival rate among patients with different age,degree of tissue differentiation,tumor recurrence,cervical lymph node metastasis and postoperative radiotherapy(P<0.05).The Cox regression analysis showed that age≥60 years,poor tumor differentiation,tumor recurrence,cervical lymph node metastasis and no postoperative radiotherapy were independent risk factors influencing prognosis of patients with early tongue squamous cell carcinoma(P<0.05).Conclusion There are various factors influencing the prognosis of patients with early tongue squamous cell carcinoma,which can be improved according to the specific influencing factors,and attention should be paid to postoperative recurrence,metastasis monitoring and adjuvant therapy to improve the prognosis of patients.