喉癌等离子射频消融术后局部复发的影响因素分析

Influencing factors of local recurrence of laryngeal carcinoma after plasma radiofrequency ablation

目的分析喉癌等离子射频消融术后局部复发的影响因素。方法抽取2019年1月至2020年8月于平顶山市第一人民医院接受等离子射频消融术治疗的90例喉癌患者为研究对象,回顾性分析其临床资料,统计分析影响其术后1年复发的因素。分析患者基线资料以及肿瘤分期、合并症等因素对其术后局部复发的影响。结果90例患者,术后1年局部复发27例(30%)。单因素分析结果显示,年龄>55岁、有饮酒/吸烟史、喉癌位于声门下区者更易发生局部复发(P<0.05);病理分期/N分期/T分期越高以及肿瘤累及前联合者越容易复发(P<0.05),性别、肿瘤累计声带突、向深部累计声带、合并症以及切缘情况均对复发无显著影响(P>0.05)。COX分析结果显示,高龄(>55岁)、肿瘤部位(声门下区)、高肿瘤分期(Ⅲ级病理分期、N2分期、T2分期)均为喉癌术后复发的危险因素(P<0.05),无饮酒/吸烟史、肿瘤未累计前联合是喉癌术后复发的保护因素(P<0.05)。结论采用等离子射频消融术治疗的喉癌患者,术后1年复发与年龄、肿瘤位置、分期等多种因素有关。

Objective To analyze the influencing factors of local recurrence of patients with laryngeal carcinoma after plasma radiofrequency ablation.Methods A total of 90 patients with laryngeal carcinoma undergoing plasma radiofrequency ablation in Pingdingshan First People’s Hospital from January 2019 to August 2020 were selected as research objects.Their clinical data were retrospectively analyzed,and factors affecting 1-year postoperative local recurrence were recorded and analyzed.The influence of baseline data,tumor staging and complications on postoperative local recurrence was analyzed.Results Among the 90 patients with laryngeal carcinoma 27 cases(30%)had local recurrence 1 year after surgery.The results of univariate analysis showed that patients over 55 years,with drinking/smoking habits and laryngeal carcinoma in subglottic region were more prone to local recurrence(P<0.05).The patients with higher pathological staging/N staging/T staging,and tumor involvement to anterior commissure were more easily to have recurrence(P<0.05).While gender,tumor involvement to processus vocalis,deep involvement to vocal cords,complications and resection margin had no effect on recurrence(P>0.05).Results of COX analysis showed that advanced age(>55 years),tumor site(subglottic region)and high tumor staging(grade III pathological stage,N2 stage,T2 stage)were all risk factors of postoperative recurrence in laryngeal carcinoma(P<0.05),while no drinking/smoking habits and tumor involvement to anterior commissure were protective factors(P<0.05).Conclusions For patients with laryngeal carcinoma undergoing plasma radiofrequency ablation,the recurrence at 1 year after surgery is related to age,tumor site and staging.