经首次根治性手术治疗口腔鳞状细胞癌患者的生存相关影响因素分析  

Survival analysis of patients with oral squamous cell carcinoma treated by radical surgery for the first time

作　　者：薛伶俐 李雅冬[1] Xue Lingli;Li Yadong(Dept.of Oral and Maxillofacial Surgery,The First Affi liated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第一医院颌面外科

出　　处：《国际口腔医学杂志》2020年第2期166-174,共9页International Journal of Stomatology

基　　金：重庆市科学技术委员会自然科学基金(cstc2018jcyjAX07-63);重庆市卫生与计划生育委员会医学高端后备人才培养项目(2017-HBRC004);重庆市教育委员会资助项目(15SKG032)~~

摘　　要：目的分析口腔鳞状细胞癌(OSCC)患者的总体生存率,以及影响生存率的临床病理因素。方法采集对首次接受根治性外科手术治疗的78例OSCC患者的临床病理及随访资料进行回顾性分析。对计数、计量资料进行描述性分析;采用Kaplan-Meier法绘制生存曲线;采用COX比例风险回归模型进行单因素和多因素分析,分析患者的生存率及预后相关影响因素。结果最终纳入生存分析的患者共计68例,中位随访时间为63(6~87)个月,5年总体存活率为55.9%,随访期间因OSCC死亡患者的中位生存时间为20.5(6~52)个月。单因素分析表明,临床分期、原发灶大小、淋巴结转移、病理分化及复发转移是影响生存时间的暴露因素(P<0.05);多因素分析表明,病理分化、复发转移是影响生存时间的独立危险因素(P<0.05)。78例OSCC患者中合并发生食道鳞状细胞癌(ESCC)者有4例(5.1%)。结论根据肿瘤的临床分期(TNM分期)、原发灶大小、淋巴结转移、病理分化及复发转移可对患者的生存预后作出一定的预测,其中病理分化及复发转移是影响生存预后的独立危险因素。有吸烟饮酒史的OSCC患者应常规进行ESCC临床筛查。Objective To analyze the overall survival(OS)and relevant risk factors for oral squamous cell carcinoma(OSCC)patients.Methods To retrospectively review the clinical,pathological,and follow-up records of 78 patients after primary radical tumor resection.Descriptive statistics were calculated for each variable,survival was calculated using the Kaplan-Meier method,differences in OS rate were analyzed via a log-rank test,and univariate and multivariate Cox proportional hazard models were performed to analyze the factors associated with overall survival and prognosis.Results A total of 68 patients were included in the fi nal study.The fi ve-year OS rate was 55.9%.The median survival time of the patients who died of this disease within fi ve years was 20.5(6–52)months.The univariate analysis showed that clinical stage,tumor size,lymph node metastasis,pathological differentiation,recurrence,and metastasis were the exposure factors affecting survival time(P<0.05).Multivariate analysis showed that pathological differentiation,recurrence,and metastasis were in-dependent factors affecting survival time(P<0.05).The patients with esophageal squamous cell carcinoma accounted for 5.1%(4/78)in total 78 OSCC.Conclusion The survival prognosis of patients with oral squamous cell carcinoma is correlated with clinical stage(TNM stage),tumor size,lymph node metastasis,pathological differentiation,recurrence,and metastasis.In this study,pathological differentiation,recurrence,and metastasis were independent factors affecting survival time.Some OSCC patients may be screened for esophageal squamous cell carcinoma.

关 键 词：口腔鳞状细胞癌 存活率 预后 影响因素 食道鳞状细胞癌 

分 类 号：R739.8[医药卫生—肿瘤]