229例晚期舌鳞癌患者的生存和预后分析  

Survival Analysis of 229 Patients with Advanced Squamous Cell Carcinoma of the Oral Tongue

作　　者：杨安奎[1,2] 刘天润[1,2] 陈福进[1,2] 马秀芳[1,3] 郭朱明[1,2] 宋明[1,2] 李秋梨[1,2] 曾宗渊[1,2] 

机构地区：[1]华南肿瘤学国家重点实验室,广东广州510060 [2]中山大学肿瘤防治中心头颈科,广东广州510060 [3]中山大学肿瘤防治中心信息科,广东广州510060

出　　处：《癌症》2008年第12期1315-1320,共6页Chinese Journal of Cancer

摘　　要：背景与目的:晚期舌癌的的治疗欠规范,预后更差,目前针对晚期舌癌预后的相关因素等方面的研究较少,本研究旨在探讨影响晚期(Ⅲ～Ⅳ期)舌鳞状细胞癌患者预后的临床病理因素。方法:选择1985年1月至1999年12月间中山大学附属肿瘤医院首治的经病理确诊且随访资料完整的晚期舌鳞癌患者共229例。应用Kaplan-Meier法分析生存结果,通过Cox回归模型确立影响预后的独立因素。建立预后风险预测函数并进行可靠性分析。结果:229例晚期舌鳞癌患者的平均生存时间为80.33个月,2年和5年生存率分别为50.66%和37.99%。单因素分析显示,影响晚期舌鳞癌患者预后的因素包括年龄、侵犯舌根、淋巴结转移、分期、手术治疗及有无复发和肿瘤残留等。多因素分析得出影响预后的独立因素为肿瘤侵犯中线、淋巴结转移、手术治疗及肿瘤残留或复发。预后风险预测函数能够较好地预测预后。结论:晚期舌鳞癌患者预后差,影响预后的独立因素为肿瘤侵犯舌中线、淋巴结转移、手术治疗及有无复发和肿瘤残留。BACKGROUND ＆ OBJECTIVE. Patients with advanced squamous cell carcinoma （SCC） of the oral tongue have poor prognosis. This study was to analyze the most important factors affecting the prognosis of the patients with advanced （stage Ⅲ and Ⅳ） SCC of the oral tongue. METHODS. Complete clinical and follow-up data of 229 patients with pathologically confirmed advanced SCC of the oral tongue, initially treated at Sun Yat-sen University Cancer Center were retrospectively analyzed. Survival analysis was performed using the Kaplan-Meier analysis, comparison among groups was analyzed using log-rank test, and multivariate analysis was conducted using the Cox proportional hazard model. Independent risk factors were deducted. The risk function was established and evaluated. RESULTS： The mean survival time of the 229 patients was 80.33 months, with the two- and five- year survival rates of 50.66% and 37.99%, respectively. Univariate analysis showed that age, tongue base invasion, cervical lymphatic metastasis, stage, surgical treatment, recurrence and residual tumor were risk factors affecting prognosis （P〈0.05）. Multivariate analysis indicated that tumour invasion across the midline, cervical lymphatic metastases, surgical treatment, recurrence and residual tumor were independent factors for prognosis. Moreover, the risk function effectively predicted the prognosis. CONCLUSIONS. The prognosis of patients with advanced SCC of the oral tongue is poor. Tumour invasion across the midline, cervical lymphatic metastasis, surgical treatment, recurrence, and residual tumor are independent factors affecting the prognosis.

关 键 词：口腔肿瘤 鳞癌 舌 生存分析 预后因素 

分 类 号：R739.8[医药卫生—肿瘤]