临床Ⅰ、Ⅱ期舌体鳞癌患者预后的多因素分析

Multivariate Analysis of Prognosis of Patients with Clinical StageⅠ and Ⅱ Carcinoma of Mobile Tongue

背景与目的:影响临床Ⅰ、Ⅱ期舌体鳞癌患者预后的因素很多,本文旨在探讨影响其预后的主要因素。方法:回顾性分析147例临床Ⅰ、Ⅱ期舌体鳞癌的长期随访资料,生存分析采用寿命表法,组间比较用log-rank检验,多因素分析采用Cox模型及Logistic回归分析。结果:单因素分析提示病理分级(中、低分化鳞癌)、颈淋巴结阳性、病理分期(Ⅲ、Ⅳ期)、饮酒史、原发灶复发、继发灶复发、原发灶和继发灶复发以及肿瘤复发均是影响预后的危险因素(P<0.05);多因素分析发现局部区域复发(P=0.000)和病理分期(P=0.045)影响预后;Logistic回归分析提示颈淋巴结阳性(P=0.003)和饮酒史(P=0.012)与局部区域复发显著相关。结论:影响临床Ⅰ、Ⅱ期舌体鳞癌预后的主要因素是局部区域复发和病理分期(Ⅲ、Ⅳ期),而颈淋巴结阳性和饮酒史是局部区域复发的危险因素。

BACKGROUND & OBJECTIVE:There are many factors affecting the prognosis of the patients with clinical stageⅠ and Ⅱ carcinoma of mobile tongue. This study was designed to analyze the most important factors affecting the prognosis. METHODS:The data of long period follow up were analyzed retrospectively for 147 patients with clinical stageⅠ and Ⅱ squamous cell carcinoma of mobile tongue to evaluate the contribution of every factors influencing on survival. Survival analysis was performed by life table method; comparison among/between groups was performed using log rank test; multivariate analysis was carried out using Cox proportional hazard model and Logistic regression model. RESULTS:Univariate analysis showed that pathological grade(G2 and G3), status of cervical lymph node, pathological stage(stageⅢ and Ⅳ), history of alcohol consumption, primary location recurrence, regional recurrence, primary location and regional recurrence,and cancer recurrence were risk factors of the prognosis of the patients (P< 0 05). Multivariate analysis showed that locoregional recurrence (P=0 000) and pathological stage (P=0 045) could predict the prognosis. The result of Logistic regression model indicated that status of cervical lymph node (P=0 003) and history of alcohol consumption (P=0 012) were closely associated with locoregional recurrence. CONCLUSION:Locoregional recurrence and pathological stage(stage Ⅲ and Ⅳ) are the most important factors affecting the prognosis of the patients with clinical stageⅠ and Ⅱ squamous cell carcinoma of mobile tongue. The risk factors affecting locoregional recurrence of the patients are positive cervical lymph node and history of alcohol consumption.