63例涎腺腺样囊性癌患者预后相关因素的Cox模型分析  

Cox proportional hazard model analysis of 63 cases of adenoid cystic carcinoma of salivary gland

作　　者：农晓琳[1] 陈琦[1] 黎燕宁[2] 李昊[1] 杨亦萍[3] 卿海云[3] 曹阳[3] 

机构地区：[1]广西医科大学口腔医学院口腔颌面外科,南宁530021 [2]广西医科大学公共卫生学院流行病与卫生统计学教研室,南宁530021 [3]广西医科大学口腔医学院病理科,南宁530021

出　　处：《口腔医学》2011年第1期1-4,8,共5页Stomatology

基　　金：国家自然科学基金(30060082);教育部"春晖计划"科研启动基金(教外司留[2003]593号);广西自然科学基金重点资助项目(2010GXNSFD013047);广西科学基金(桂科回0836013);广西卫生厅重点科研项目(重200006和重200927);中国高等教育学会"十一五"教育科学研究规划立项课题(06AIL0770110)

摘　　要：目的探讨影响涎腺腺样囊性癌(adenoid cystic carcinoma,ACC)患者术后生存的相关因素。方法回顾性分析1988年1月—2005年10月在我院手术治疗并经病理确诊的63例涎腺ACC患者临床资料,对可能影响患者术后生存的指标进行Kaplan-Meier检验后,采用Cox比例风险回归模型进行多因素分析。结果 63例涎腺ACC患者术后3、5、10年的总生存率分别为77.64%、68.31%、39.26%,无瘤生存率分别为65.73%、57.17%、38.92%。Cox比例风险回归模型多因素分析结果显示:TNM分期、病理类型、神经侵犯、手术方式、放/化疗、局部复发及远处转移是影响患者术后生存的重要因素。结论高TNM分期、实性病理类型、神经周围侵犯、有局部复发及远处转移等是涎腺ACC患者术后生存的危险因素,能缩短术后生存时间;手术加放/化疗是保护因素。Objective To study factors of survival rate of patients with adenoid cystic carcinoma（ACC） of salivary gland.Methods 63 cases were studied to investigate factors influencing the survival rate of patients.The data were statistically analyzed by Kaplan-Meier analysis.Cox regression model was used for multivariate analysis.Results The over-all survival rates of 63 cases in disease for 3,5 and 10 years were 77.64%,68.31%,39.26% and the tumor-free survival rates were 65.73%,57.17%,38.92% respectively.Multivariate analysis of Cox proportional hazard model showed that TNM stage,pathological type,nerve invasion,surgical method,radiotherapy chemotherapy,local recurrence and distant metastasis were important factors for the long-term survival of patients.Conclusions Higher TNM stage,solid pathological type,perineual invasion,local recurrence and distant metastasis are risk factors for the long-term survival of patients,which can reduce the survival time after operation.Surgical operation with radiotherapy/chemotherapy are protective factors.Combination therapy plays an important role in influencing the long-term survival of SACC patients.

关 键 词：涎腺 腺样囊性癌 COX比例风险回归模型 生存分析 

分 类 号：R739.87[医药卫生—肿瘤]