口腔癌预后及生存质量的影响因素研究

Influencing factors for prognosis and quality of life in oral cancer

目的分析口腔癌患者术后预后及生存质量的影响因素。方法收集389例湖南省常德市第一人民医院口腔癌手术患者的临床资料,绘制生存曲线,采用Cox回归模型分析其影响预后的因素。采用华盛顿大学生活质量问卷(UW-QOL)对术后生存患者的生活质量进行评估,分析其预后影响因素。结果单因素分析结果显示:不同年龄,咀嚼槟榔史,肿瘤原发灶大小,淋巴结转移数目,TNM分期情况的口腔癌患者生存曲线差异有统计学意义(P<0.05);Cox多因素回归分析结果显示:咀嚼槟榔史,肿瘤原发灶大小,淋巴结转移数目,TNM分期情况均是口腔癌患者预后的独立影响因素(P<0.05);婚姻状况中的患者术后UW-QOL评分较高(P<0.05)。结论口腔癌患者咀嚼槟榔史,肿瘤原发灶大小,淋巴结转移数目,TNM分期情况均影响预后,婚姻状况影响其术后生存质量。因此,应对患者进行健康教育及个人生活习惯建议,改善其预后,并增加社会和家庭关爱以提高其术后生存质量。

【Objective】To analyze the affecting factors of postoperative prognosis and quality of life in patients with oral cancer.【Methods】The clinical data of 389 patients with oral cancer surgery in our hospital were collected,the survival curve was drawn,and the Cox regression model was used to analyze the factors affecting the prognosis.The University of Washington Quality of Life Questionnaire(UW-QOL)was used to evaluate the quality of life of patients who survived postoperatively,and their prognostic factors were analyzed.【Results】Univariate analysis indicated that the survival curves of oral cancer patients with different age,history of chewing areca nut,the size of the primary tumor,number of lymph node metastasis,and TNM staging were significantly different,and the difference was statistically significant(P<0.05).Cox multivariate regression analysis indicated that the history of chewing areca nut,the size of the primary tumor,the number of lymph node metastasis,and TNM staging were all independent prognostic factors for oral cancer patients,and the difference was statistically significant(P<0.05).The postoperative UW-QOL scores of oral cancer patients with different marital status were compared,and the difference was statistically significant(P<0.05),and the postoperative UW-QOL scores of married patients were higher.【Conclusion】The history of chewing areca nut,the size of primary tumor,the number of lymph node metastasis,and TNM staging of oral cancer patients affect the prognosis,and marital status affects the postoperative quality of life.Therefore,patients should be given health education and advice on personal living habits to improve their prognosis.Social and family care should be increased to improve their quality of life after surgery.