影响喉癌患者预后因素的多元逐步回归分析  

Multiple stepwise regression analysis on the influencing factors related to the prognosis of larynx cancer

作　　者：石洪金[1,2] 李贵泽[1] 李树华[3] 

机构地区：[1]解放军第四军医大学唐都医院耳鼻咽喉科 [2]解放军沈阳军区总医院耳鼻咽喉科,辽宁省沈阳市110016 [3]解放军沈阳军区总医院耳鼻咽喉科

出　　处：《中国临床康复》2005年第22期139-141,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨喉癌术后影响预后的因素。方法:对沈阳军区总医院耳鼻喉科1992-01/1998-12年收入院手术的209例喉癌标本中随机筛选40例。①40例中按肿瘤TNM分型:声门上型21例,声门型19例,无声门下型;T分期:T210例,T322例,T48例。②患者吸烟情况:20例不吸烟,20例吸烟。③进行5年以上随访,以性别、年龄、病史、吸烟总量、A型血、B型血、AB型血、O型血、术中输血、肿瘤分型、手术范围、颈清扫、肿瘤病理分型、术后放疗、T分期、N分期、肿瘤分期、肿瘤生长方式为自变量,多因素逐步回归分析喉癌手术后影响预后的因素。结果:①门坎值F=2引入变量,筛选出T分期、吸烟总量及喉癌分型共3项影响预后的显著性因素,他们的偏回归系数分别是-0.453,-0.638,-0.599。②筛选出T分期、吸烟总量及喉癌分型共3项影响预后的显著性因素,吸烟量愈大,T分期愈晚及声门上型患者,预后愈差。结论:①吸烟是一个对喉癌预后有重要影响的因子,喉癌的分型是影响喉癌生存的因素,声门上型喉癌患者较声门型的预后差,局部复发和颈部转移随T分期的提高而增加。②T分期高,吸烟量大,TNM分型为声门上型,是影响喉癌的预后的主要因素。AIM:To investigate the factors influencing prognosis of postoperative larynx cancer. METHODS:Forty cases of laryngeal carcinoma were randomly selected from 209 patients who were hospitalized to operate in the Department of Otolaryngology,General Hospital of Shenyang Military Area Command between January 1992 and December 1998.①In the 40 cases,types according to TNM stages were:upper glottis larynx cancer in 21,glottis in 19 and no subglottis;T stage was as follows:T2 stage in 10,T3 stage in 22 and T4 in 8.②In the 40 patients,20 smoked and 20 did not.③After the over 5 years' follow-up,multiple stepwise regression analysis for the factors influencing the prognosis of larynx cancer was performed using the following independent variables:gender,age,history of illness,total amount of smoking,blood type A,B,AB and O,intra-operative blood transfusion,tumor typing,range of operation,neck dissection,pathological types of tumors,postoperative radiotherapy,T stages,N stages,tumor staging and manner of tumor growth. RESULTS:①When the threshold F=2 was introduced as variable,T staging,total amount of smoking and larynx cancer typing were significant in influencing factors of the prognosis,and their partial regression coefficients were -0.453,-0.638,-0.599 respectively.②In the elected three influencing factors of the prognosis,more total amount of smoking,later T staging and upper glottis larynx cancer induced worse prognosis of larynx cancer. CONCLUSION:①Smoking is one of the most important factors that influence the prognosis of larynx cancer,and typing of larynx cancer is the factor that influences the existence of larynx cancer.The prognosis is worse in the patients with upper glottis larynx cancer than in those with glottis larynx cancer.The higher the T stage is,the more aggravated the local reoccurrence and the cervical metastasis are.②High T stage,great total amount of smoking and upper glottis larynx cancer in TNM staging are three main factors influencing the prognosis of larynx cancer.

关 键 词：多元逐步回归分析 喉癌患者 预后因素 多因素逐步回归分析 沈阳军区总医院 声门上型 肿瘤生长方式 T分期 喉癌术后 随机筛选 耳鼻喉科 声门下型 吸烟情况 AB型血 术中输血 肿瘤分型 手术范围 病理分型 术后放疗 肿瘤分期 

分 类 号：R197.322[医药卫生—卫生事业管理] R739.65[医药卫生—公共卫生与预防医学]