124例舌根鳞状细胞癌临床总结及预后分析  

Clinical features and prognostic factors of squamous cell carcinoma of the base of tongue:an analysis of 124 cases

作　　者：张永侠 刘明波[1] 黄辉[2] 陈汶[3] 张彬[2,4] 

机构地区：[1]中国人民解放军总医院耳鼻咽喉头颈外科,北京100853 [2]北京协和医学院中国医学科学院肿瘤医院头颈外科 [3]北京协和医学院中国医学科学院肿瘤医院流行病学教研室 [4]北京大学肿瘤医院头颈外科,北京100142

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第24期1867-1872,共6页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：解放军总医院科技创新苗圃基金(No:16KMM23)

摘　　要：目的:总结舌根鳞状细胞癌临床病理特征并分析其预后风险因素。方法:回顾性分析124例舌根鳞状细胞癌患者的临床资料。HPV-DNA检测采用HPV SPF10PCR/DEIA检测和LiPA分型法。生存率及单因素生存分析采用Kaplan-Meier法和Log-rank检验,多因素生存分析采用Cox回归模型。结果:124例舌根鳞状细胞癌患者5年疾病特异生存率为54.5%,总生存率为48.5%,中位总生存时间45.2个月。舌根鳞状细胞癌HPV感染率为18.3%(11/60),其中HPV-16亚型10例,占90.9%(10/11)。单因素分析结果显示长期吸烟史(P=0.028)、酗酒史(P=0.001)、肿瘤分期(P=0.009)及p16(P=0.015)蛋白表达情况均显著影响患者预后;HPV阳性舌根癌预后虽好于HPV阴性患者(5年生存率分别为80.8%和54.5%),但差异无统计学意义(P=0.138)。多因素生存分析显示影响舌根癌的独立预后因素为酗酒史(P=0.006)和肿瘤分期(P=0.035)。结论:舌根鳞状细胞癌预后相对较差,吸烟史、酗酒史、肿瘤分期及p16蛋白表达情况均显著影响患者预后,其中酗酒史和肿瘤分期为舌根癌的独立预后因素。Objective：To summarize the clinicopathological characteristics and prognostic factors of squamous cell carcinoma（SCC）of the base of tongue（BOT）.Method：Review the clinical data of 124 cases of patients with BOT tumors.HPV-DNA was detected using SPF10-DNA enzyme immunoassay and LiPA genotyping method.Survival rates and prognostic factors was calculated with SPSS 19.0 software using the Kaplan-Meier method and multivariate Cox model survival analysis.Result：5-year disease-specific survival（DSS）,5-year overall survival and median survival time for patients with SCC BOT were 54.5%,48.5%and 45.2 months,respectively.HPV infection rate was 18.3%（11/60）,the HPV-16 subtype in 10 cases,accounting for 90.9%（10/11）.Univariate analysis results showed that smoking history（P=0.028）,drinking history（P=0.001）,tumor stage（P=0.009）and p16 protein expression（P=0.015）significantly affected the prognosis.The prognosis of patients with HPV positive BOT cancers was better than the HPV negative patients（5-year DSS was 80.8% compared to 54.5%）,but not statistical difference（P=0.138）.Multivariate analysis revealed that independent prognostic factors of BOT tumors were drinking history（P=0.006）and tumor stage（P=0.035）.Conclusion：The prognosis of BOT tumor was relatively poor.Smoking history,drinking history,tumor staging and the expression of p16 protein significantly affected the prognosis.Drinking history and tumor stage were independent prognostic factors for BOT cancers.

关 键 词：舌根 癌 鳞状细胞 人乳头状瘤病毒 临床特点 预后 

分 类 号：R739.86[医药卫生—肿瘤]