声门上喉癌预后的相关因素分析  

Prognostic Factor Analysis in Patients with Supraglottic Cancer

作　　者：郭剑锋[1] 陈福进[1] 曾宗渊[1] 伍国号[1] 杨安奎[1] 张诠[1] 

机构地区：[1]中山大学肿瘤防治中心头颈科,广东广州510060

出　　处：《中山大学学报（医学科学版）》2005年第2期236-239,共4页Journal of Sun Yat-Sen University:Medical Sciences

摘　　要：【目的】探讨影响声门上喉癌患者预后的主要因素。【方法】回顾性分析111例临床声门上喉癌的长期随访资料,生存分析采用Kaplan-Meier法,各因素问比较用log-rank检验,多因素分析采用Cox模型。【结果】单因素分析提示肿瘤原发灶部位、病理学分级、颈淋巴结转移、原发灶治疗方式均有统计学意义(P<0.05): 多因素分析发现颈淋巴结有无转移(P=0.000)和原发灶治疗方式(P=0.000)对预后的影响有统计学意义。【结论】影响声门上喉癌预后的因素为肿瘤原发灶部位、病理学分级、颈淋巴结转移、原发灶治疗方式,其中独立预后因素为颈淋巴结转移和原发灶治疗方式。对于声门上喉癌患者。应选择以手术为主的治疗方式,有颈淋巴结转移者应行颈清扫术,临床未发现颈淋巴结转移的T3以上患者应行Ⅱ、Ⅲ区以及必要时包括Ⅳ区的颈清扫术。[Objective] This study was designed to analyze the factors affecting the prognosis of the patients with supraglottic cancer.[Methods] The data of long period follow-up were analyzed retrospectively for 111 patients with supraglottic cancer to evaluate the contribution of every factors influencing on survival. Survival analysis was performed by Kaplan-Meier method. The factors were compared using the log-rank test. The influencing factors were screened by Cox proportional hazards model. [Results] Univariate analysis showed that primary site, pathological grade, status of cervical lymph node, therapy manner of primary tumor were proven to significant (P<0.05). Multivariate analysis showed the prognosis statistically correlated with status of cervical lymph node (P=0.000) and therapy manner of primary tumor (P=0.000). [Conclusion] The factors affecting the prognosis of the patients with supraglottic cancer are primary site, pathological grade,status of cervical lymph node,therapy manner of primary tumor;the independent factors are status of cervical lymph node and therapy manner of primary tumor. Surgery is the principal treatment modality for supraglottic cancer, neck dissection should be performed in patients with lymph node positive cervical metastasis,Ⅱ and Ⅲ levels should be dissected in T3-T4 patients with lymph node negative cervical metastasis and Ⅳ level should be included when Ⅲ level is involved.

关 键 词：喉肿瘤 鳞状细胞癌 多因素分析 预后 

分 类 号：R739.65[医药卫生—肿瘤]