基于SEER数据库的头颈部腺样囊性癌预后因素Meta分析

Meta analysis of prognostic factors of adenoid cystic carcinoma of the head and neck patients based on SEER database

目的头颈部腺样囊性癌(ACCHN)是唾液、腮腺和下颌下腺的罕见肿瘤。大样本研究对ACCHN的研究很少。本研究目的是评估ACCHN患者的人口统计学和生存模式。方法数据来自美国国家癌症研究所的SEER数据库。根据性别、种族、年龄、婚姻状况、原发肿瘤部位和疾病阶段对2006-2016年报道的新诊断ACCHN病例进行分类,检查ACCHN诊断后的生存率。结果确定了1944例ACCHN患者。诊断时的平均年龄为59.4岁(11~94岁)。ACCHN患者5年总生存率为72.62%,单因素预后分析显示女性、诊断时无远处转移、AJCC分期较早者总生存率均显著提高(均P<0.001),多因素预后分析显示女性比男性预后好(HR=0.745,95%CI为0.629~0.889),有远处转移者比无转移者预后差(HR=5.232,95%CI为3.932~6.962),AJCC分期为Ⅳ、Ⅲ、Ⅱ期的较Ⅰ期患者预后更差(HR=11.418,95%CI为6.480~20.117;HR=4.092,95%CI为2.119~7.900;HR=2.369,95%CI为1.206~4.651)。结论ACCHN的预后与性别、分期相关,基于年龄、婚姻状况、种族、部位的生存率差异需要进一步研究。

Objective Adenoid cystic carcinoma of the head and neck(ACCHN)is a rare tumor of saliva,parotid gland and submandibular gland.There are few large sample studies on ACCHN.The purpose of this study was to evaluate the hazard and forecast elements of patients with ACCHN.Methods The data of ACCHN from Surveillance,Epidemiology,and End Results(SEER)program between 2010 and 2016 was evaluated.The survival rate of ACCHN was analyzed according to the gender,race,age,marital status,tumor site and stage.Results There were a total of 1944 ACCHN patients.In these cases,the average age at diagnosis was 59.4 years(range 11-94 years).The overall 5-year survival rate was 72.62%.The results showed that the survival rate of women,patients with no distant metastasis at diagnosis,and earlier AJCC stage was significantly improved(all P<0.001).Multivariate analysis showed that women had better prognosis than men(HR=0.745.95%CI 0.629-0.889).and those with distant metastases had worse prognosis than those without metastases(HR=5.232,95%CI 3.932-6.962).AJCC stage Ⅳ、Ⅲ、Ⅱ patients have worse prognosis than stage Ⅰ patients(HR=11.418,95%CI 6.480-20.117;HR=4.092,95%CI 2.119-7.900;HR=2.369,95%CI 1.206-4.651).Conclusions The prognosis of ACCHN is related to gender and stage.The difference in survival rates based on age,marital status,race and location needs further research,