癌结节与Ⅲ/Ⅳ期口腔鳞状细胞癌患者病理特征及预后的相关性

Correlation analysis of pathological characteristics and prognosis between tumor deposits and stageⅢ/Ⅳoral squamous cell carcinoma

目的:分析癌结节在临床Ⅲ-Ⅳ期口腔鳞状细胞癌患者中出现的比率及其与口腔鳞癌患者病理特征和预后的关系。方法:回顾性分析2012年1月-2018年6月山西医科大学第一医院口腔颌面外科诊治的234例临床Ⅲ-Ⅳ期口腔鳞癌患者的资料,采用SPSS 22.0软件包,应用单因素和多因素Logistic回归分析探讨癌结节与患者病理特征的相关性,应用单因素和多因素生存分析探讨癌结节与患者预后的相关性,P<0.05为差异有统计学意义。结果:234例患者中癌结节阳性率为17.95%(42例)。单因素Logistic回归分析显示,pT分期、pN分期、分化程度、淋巴结比率和脉管癌栓与癌结节的发生具有相关性(P<0.05)。多因素Logistic回归分析显示,淋巴结比率和脉管癌栓是癌结节存在的独立危险因素(P<0.05)。癌结节是影响患者预后的独立危险因素(P<0.05),癌结节阳性患者5年生存率显著低于阴性患者(P<0.05),死亡风险是癌结节阴性患者的3.836倍(P<0.05)。结论:癌结节的出现可能与颈淋巴结转移和脉管癌栓有关,癌结节是影响Ⅲ-Ⅳ期口腔鳞癌患者预后的不良特征。

Objective:To analyze the incidence of tumor deposits in patients with stageⅢ-Ⅳoral squamous cell carcinoma(OSCC)and its relationship with pathological characteristics and prognosis.Methods:The data of 234 patients with stageⅢ-ⅣOSCC treated in oral and maxillofacial surgery of the First Hospital of Shanxi Medical University from January 2012 to June 2018 were retrospectively analyzed.Univariate and multivariate logistic regression analysis was used to explore the correlation between tumor deposits and pathological characteristics in OSCC patients.Univariate and multivariate survival analysis was used to explore the correlation between tumor deposits and prognosis of OSCC with SPSS 22.0 software package.P<0.05 was statistically significant.Results:The positive rate of tumor deposits in this group was 17.95%(42/234).Univariate logistic regression analysis showed that pT stage,pN stage,differentiated degree,lymph node ratio and lymphovascular invasion were correlated with the occurrence of tumor deposits(P<0.05).Multivariate logistic regression analysis showed that lymph nodes ratio and lymphovascular invasion were independent risk factors for the presence of tumor deposits(P<0.05).Tumor deposits was an independent risk factor for the prognosis of oral cancer patients in this group(P<0.05).The 5-year survival rate of tumor deposits positive patients was significantly lower than that of negative patients(P<0.05),and the risk of death was 3.836 times higher than that of patients with negative tumor deposits(P<0.05).Conclusion:The appearance of tumor deposits may be related to cervical lymph node metastasis and lymphovascular invasion.Tumor deposits are an undesirable characteristic affecting the prognosis of stageⅢ-ⅣOSCC patients.