复发性舌鳞状细胞癌复发时间及预后相关影响因素研究

Study on recurrence time and prognostic factors of recurrent tongue squamous cell carcinoma

目的分析复发性舌鳞状细胞癌(recurrent tongue squamous cell carcinoma,rTSCC)患者的复发时间及预后相关影响因素。方法收集2012年1月至2017年6月于上海交通大学医学院附属第九人民医院及上海市奉贤区奉城医院口腔颌面-头颈肿瘤科就诊的177例rTSCC患者临床病理资料及生存信息,对复发时间及预后的相关影响因素进行分析。结果复发病灶可累及对侧舌体、口底、舌骨、下颌骨、会厌、咽旁、舌根等解剖结构;rTSCC患者的复发时间与患者性别、吸烟史显著相关,差异均有统计学意义(均P<0.05);对比分析患者3年及5年生存率发现,复发肿瘤T分期、复发肿瘤手术切缘性质、复发肿瘤N分期、复发肿瘤临床分期及复发肿瘤病理分级与复发患者的预后显著相关,且上述因素及肿瘤复发时间均影响患者的生存率,差异均有统计学意义(均P<0.05)。结论临床医生应注重完善分析rTSCC患者的分期、分级等数据,并嘱患者养成良好的生活习惯,以延长患者的生存期。

Objective The risk factors related to recurrence time and prognosis of recurrent tongue squamous cell carcinoma(rTSCC)were analyzed.Methods A total of 177 rTSCC patients admitted to the Ninth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and the Department of Oral and Maxillofacial-Head and Neck Oncology of Fengcheng Hospital,Fengxian District,Shanghai,from January 2012 to June 2017 were collected.Clinicopathological data and survival information of the patients were collected.The factors related to recurrence time and prognosis of rTSCC patients were analyzed.Results Recurrent lesions may involve the anatomical structures of the contralateral tongue,floor of the mouth,hyoid bone,mandible,epiglottis,parapharynx,and tongue base.The recurrence time of rTSCC patients was significantly correlated with gender and smoking history,and the differences were statistically significant(P<0.05).Comparative analysis of the 3-year survival rate and 5-year survival rate of patients showed that the T stage,surgical margin,N stage,clinical stage and histopathological grade of recurrent tumor were significantly correlated with the prognosis of recurrent patients,and the above factors and the time of tumor recurrence all affected the overall survival of patients,the difference being with statistical significance(P<0.05).Conclusion Clinicians should focus on improving the analysis of staging,grading and other data of r TSCC patients,and advise patients to develop good living habits,in order to prolong the survival time of patients.