经口内镜下CO_2激光切除Tis～T2期声门型喉癌复发相关因素分析  

The Analysis of the Recurrence Factors of CO_2 Laser Surgery for Tis,T1 and T2 Glottic Cancer

作　　者：万光伦[1] 葛冲[1] 孙敬武[1] 陈浩[1] 赵婉[1] 

机构地区：[1]安徽医科大学安徽省立医院耳鼻咽喉头颈外科,合肥230001

出　　处：《听力学及言语疾病杂志》2017年第6期619-622,共4页Journal of Audiology and Speech Pathology

基　　金：国家自然科学基金青年项目(81600793);安徽省自然科学基金青年项目(1608085QH224)资助

摘　　要：目的探讨经口内镜下CO_2激光手术治疗的Tis、T1、T2期声门型喉癌患者术后复发的相关因素。方法回顾性分析在安徽省立医院接受经口内镜下CO_2激光治疗的180例Tis^T2期声门型喉癌患者的临床资料,其中Tis 22例,T1a90例,T1b32例,T2 36例;以肿瘤复发为终点,运用单因素及多因素方法分析年龄、性别、肿瘤T分期、手术方式、病理分级、声带运动、前联合是否受累等因素对复发率的影响。结果 Tis患者的复发率为9.09%(2/22),T1a患者的复发率为13.33%(12/90),T1b患者的复发率为18.75%(6/32),T2患者的复发率为38.89%(14/36);Ⅰ型手术患者术后复发率为0,Ⅱ型手术患者术后复发率为3.57%(1/28),Ⅲ型手术患者术后复发率为15.0%(9/60),Ⅳ型手术患者术后复发率为19.60%(10/51),Ⅴ型手术患者术后复发率为36.84%(14/38)。不同肿瘤T分期及不同手术方式患者复发率之间差异有显著统计学意义(P=0.006);单因素Logistics回归分析示T2期(OR=6.36,P<0.05)及手术方式(OR=2.06,P<0.05)与术后复发率显著相关,多因素Logistics回归分析手术方式(OR=1.71,P<0.05)是术后复发率的独立影响因素。结论声门型喉癌复发率与T分期及手术方式密切相关,随着T分期及手术等级的增高患者复发率随之升高,手术方式是术后复发的独立危险因素。Objective To study the risk factors for recurrence in glottic cancer at Tis,T1 and T2 stage after CO_2 laser endoscopic resection.Methods We conducted a retrospective analysis of 180 Tis,T1 and T2 glottic cancer cases treated by CO_2 laser surgery.Of the total cases,the Tis stage lesion was found in 22 cases,the T1 ain 90,the T1 bin 32 and the T2 in 36 cases.Tumor recurrence was set as the time-related endpoint.The recurrence factors were analyzed by univariate and multivariate analysis,including age,gender,T classification,type of cordectomy,tumorgrading,motility of vocal fold and the possible anteior commissure.Results There was a significant statistical difference between the recurrence rate and T classification,and the type of cordectomy(P<0.05).The recurrence rates of Tis,T1 a,T1 band T2 were 9.1%,13.3%,18.8% and 38.9%,respectively.In type-Ⅰ,Ⅱ,Ⅲ,Ⅳand Ⅴ of cordectomy,the recurrence rates were 0,3.57%,15.0%,19.60% and 36.84%.Conclusion The recurrence rate is closely associated with T classification and the type of cordectomy.With the higher T classification and the type of cordectomy,the recurrence rate is dramatically higher.

关 键 词：CO2激光 声门癌 声带切除术 复发因素 

分 类 号：R739.6[医药卫生—肿瘤]