血清铁水平与口腔癌总体生存的关联  

Correlation between serum iron level and overall survival of oral cancer

作　　者：林奕霖 包晓丹[2] 李洁 潘朝敏 钱佳文 林李嵩[4] 邱宇[4] 施斌[4] 刘凤琼[2] 陈法[2] 何保昌[2] 汪靖[2] Lin Yilin;Bao Xiaodan;Li Jie;Pan Chaomin;Qian Jiawen;Lin Lisong;Qiu Yu;Shi Bin;Liu Fengqiong;Chen Fa;He Baochang;Wang Jing(School of Medical Technology and Engineering,Fujian Medical University,Fuzhou 350104,China;School of Public Health,Fujian Medical University,Fuzhou 350108,China;School of Clinical Medice,Fujian Medical University,Fuzhou 350108,China;Department of Oral and Maxillofacial Surgery,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350004,China)

机构地区：[1]福建医科大学医学技术与工程学院,福州350104 [2]福建医科大学公共卫生学院,福州350108 [3]福建医科大学临床医学部,福州350108 [4]福建医科大学附属第一医院口腔颌面外科,福州350004

出　　处：《卫生研究》2021年第5期756-762,共7页Journal of Hygiene Research

基　　金：福建医科大学大学生创新创业训练计划(No.C19135)。

摘　　要：目的探讨血清铁水平和口腔癌总体生存的关系。方法收集福建医科大学附属第一医院口腔颌面外科2010年1月至2017年4月符合纳入标准的口腔癌患者,年龄(57.12±13.94)岁,其中男性489人(65.46%),女性258人(34.54%),鳞状细胞癌564例(77.90%),运用Kaplan-Meier法计算生存率,用log-rank检验比较生存差别,用Cox比例风险回归模型分析计算死亡风险比值(HR)及其95%CI。结果口腔癌患者的血清铁水平用M(P25,P75)表示为13.9(10.3,17.8)μmol/L。根据X-tile软件得到的血清铁最佳截断值15.3μmol/L,对患者进行分组,结果显示高血清铁水平(>15.3μmol/L)口腔癌患者死亡风险是低血清铁水平组(≤15.3μmol/L)的0.72倍(95%CI 0.52~0.99)。分层分析结果提示,在年龄>60岁(HR=0.62,95%CI 0.39~0.99)、男性(HR=0.66,95%CI 0.44~0.98)、TNM分期为I~II期(HR=0.42,95%CI 0.20~0.88)、病理类型为鳞状细胞癌(HR=0.69,95%CI 0.49~0.97)的患者中,高血清铁水平对口腔癌的预后具有保护作用。结论血清铁与口腔癌的总体生存密切相关,高血清铁口腔癌患者死亡风险更低。OBJECTIVE To explore the correlation between serum iron(Fe) and the overall survival of oral cancer. METHODS Patients with oral cancer who met the inclusion criteria in the Department of Oral and Maxillofacial Surgery of the First Affiliated Hospital of Fujian Medical University from January 2010 to April 2017 were collected. The average age was(57.12±13.94) years old, including 489 males(65.46%), 258 females(34.54%) and 564 cases of squamous cell carcinoma(77.90%). Overall survival rates were calculated by Kaplan-Meier method. Survival difference was compared by log-rank test. Cox regression model was used to estimate the hazard ratio(HRs) and 95% confidence intervals(95%CIs). RESULTS The distributions of serum iron level were non-normal distribution(P<0.001), and the serum iron level is expressed as 13.9(10.3,17.8)μmol/L in M(P25,P75).According to X-tile, the optimal cut-off value of serum iron was 15.3 μmol/L, used as a criterion to group patients. The result showed that the mortality risk of patients with oral cancer in high serum iron level(Fe>15.3 μmol/L) was 0.72 times of patients in lower one(Fe≤15.3 μmol/L)(95%CI 0.52-0.99). Stratified analysis suggested that serum iron was a good predictor of patients with oral cancer aged 60 years(HR=0.62, 95%CI 0.39-0.99), male(HR=0.66, 95%CI 0.44-0.98), with TNM stage I-II(HR=0.42, 95%CI 0.20-0.88) and squamous cell of pathological type(HR=0.69, 95%CI 0.49-0.97). CONCLUSION Serum iron is closely related to the overall survival of oral cancer, patients with high serum iron have a lower risk of death.

关 键 词：血清铁 口腔癌 总体生存 

分 类 号：Q581[生物学—生物化学] R739.8[医药卫生—肿瘤]