吸烟饮酒对不同年龄OSCC患者预后的影响

Effect of smoking and drinking exposure history on prognosis of patients with oral squamous cell carcinoma at different ages

目的通过分析口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)患者的临床资料,讨论吸烟饮酒对不同年龄OSCC患者预后的影响。方法收集2010年6月—2021年6月西安交通大学口腔医院颌面肿瘤外科收治的215例OSCC患者病例资料进行回顾性分析,将年龄≤45岁的患者定义为青年组患者,将年龄>45岁的患者定义为中老年组,根据是否有吸烟饮酒史进一步分组,通过分析无瘤生存率、无远处转移生存率和总生存率对患者预后进行评估。结果OSCC所有纳入病例中,青年组舌或其他位置恶性肿瘤发病率显著高于中老年组患者(P<0.05),且OSCC临床分期和分化程度与预后指标均显著相关(P<0.05);预后分析发现青年组患者吸烟饮酒史和临床分期与预后显著相关(P<0.05),中老年组患者单因素分析发现OSCC临床分期(P<0.05)与预后相关而多因素分析无相关性(P>0.05);生存分析发现青年组患者中吸烟饮酒是造成不良预后的危险因素,中老年组中无相关性。结论吸烟饮酒史对青年患者预后有较大影响,临床上应对具有吸烟饮酒史的青年OSCC患者高度关注。

Objective To explore the prognostic factors of oral squamous cell carcinoma patients(OSCC)by analyzing the clinical data,so as to focus on the influence of smoking and drinking history on the prognosis of OSCC patients in different age groups.Methods The data of 215 patients who were diagnosed with OSCC and admitted into the Department of Maxillofacial Surgery of Stomatological Hospital Affiliated to Xi′an Jiaotong University from June 2010 to June 2021 were collected and analyzed retrospectively.Patients aged≤45 years old were defined as the young group,and patients aged>45 years old were defined as the middle-aged and elderly group.Meanwhile,patients were divided into two groups according to whether they had a history of smoking and drinking exposure.The prognosis was mainly evaluated by disease free surivival,distant metastasis-free survival rate and overall survival rate.Results Among all the cases included,the incidence of tongue and other locations malignant tumor in the young group was significantly higher than that in the middle-aged and elderly group(P<0.05).By analyzing prognostic indicators of all patients,it was found that the clinical stage and differentiation degree were significantly correlated with prognostic indicators(P<0.05);among the young patients,it was found that smoking and drinking and clinical stage were significantly correlated with prognosis(P<0.05).Univariate prognostic analysis showed that clinical stage was correlated with prognosis in middle-aged and elderly patients(P<0.05),but there was no significant difference in multivariate analysis(P>0.05).Through survival rate analysis,it was found that smoking and drinking were the risk factors of poor prognosis in young patients,but there was no significant difference in middle-aged and elderly patients.Conclusion Smoking and drinking history has a great influence on prognosis in young patients.In clinical practice,attention should be paid to young patients with smoking and drinking history.