98例原发性颌骨内鳞状细胞癌预后影响因素的回顾性分析  

Prognostic factors of primary intraosseous squamous cell carcinoma:a retrospective review of98consecutive cases

作　　者：杨金刚 夏荣辉[3] 朱云[1] 吴思成 董亚兵 杨功鑫 史俊隆 崔迎慧 朱凌[6] 周晌辉[1] YANG Jin-gang;XIA Rong-hui;ZHU Yun;WU Si-cheng;DONG Ya-bing;YANG Gong-xin;SHI Jun-long;CUI Ying-hui;ZHU Ling;ZHOU Shang-hui(Department of Oromaxillofacial Head and Neck Oncology,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,College of Stomatology,Shanghai Jiao Tong University,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology,Shanghai 200011;Department of Stomatology,Shanghai Tongren Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200336;Department of Oral Pathology,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011;Biostatistics Office of Clinical Research Unit,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011;Department of Oral Surgery,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Department of Radiology,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Department of Medical Affairs,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海200011 [2]上海交通大学医学院附属同仁医院口腔科,上海200336 [3]上海交通大学医学院附属第九人民医院口腔病理科,上海200011 [4]上海交通大学医学院附属第九人民医院临床研究中心生物统计研究室,上海200011 [5]上海交通大学医学院附属第九人民医院口腔外科,上海200011 [6]上海交通大学医学院附属第九人民医院放射科,上海200011 [7]上海交通大学医学院附属第九人民医院医务一处,上海200011

出　　处：《中国口腔颌面外科杂志》2022年第3期239-243,共5页China Journal of Oral and Maxillofacial Surgery

基　　金：上海市浦江人才计划(D类,18PJD026);上海市自然科学基金(21ZR1438200)。

摘　　要：目的:总结原发性颌骨内鳞状细胞癌(PIOSCC)的临床及病理特征,对其预后影响因素进行探讨。方法:收集2013—2017年上海交通大学医学院附属第九人民医院收治的原发性颌骨内鳞状细胞癌患者的临床、影像、组织病理及术后随访资料,采用描述性统计学方法分析影响预后的因素。采用SPSS 23.0软件包将基线资料进行单因素及多因素生存分析。结果:共纳入98例患者,平均年龄56.6岁;男71例,女27例;上颌骨33例,下颌骨65例。术后随访的95例患者中,24例出现复发,10例出现远处转移,复发和远处转移多发生于术后2年内。患者的2年和5年总生存率分别为74.7%和61.8%。单因素分析显示,肿瘤部位、肿瘤大小、切缘阳性、颈淋巴结转移对总生存率有显著影响;面部麻木、切缘阳性,肿瘤部位、颈淋巴结转移分别对复发和远处转移有显著影响。多因素分析显示,仅切缘阳性和颈淋巴结转移对总生存率的影响有统计学差异。结论:术后前2年是PIOSCC患者复发、远处转移及死亡的高发期,切缘阳性及颈淋巴结转移是原发性颌骨内鳞状细胞癌的不良预后因素。PURPOSE:To delineate the clinical and pathological features and determine the prognostic factors of primary intraosseous squamous cell carcinoma(PIOSCC).METHODS:The clinical,radiological,histopathological and postoperative follow-up data of patients diagnosed with PIOSCC in Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine from 2013 to 2017 were collected,and the prognostic factors of PIOSCC were analyzed by descriptive statistical methods.Baseline data were analyzed by univariate and multivariate survival analysis with SPSS 23.0 software package.RESULTS:A total of 98 patients with PIOSCC were enrolled,with a mean age of 56.6 years.Among them,there were 71 males and 27 females,and 33 in the maxilla,65 in the mandible.Of the 95 patients followed up,24 patients developed local recurrences and 10 patients developed distant metastases;furthermore,most local recurrences and distant metastasis occurred within 2 years after operation.The estimated 2-year and 5-year overall survival were 74.7%and 61.8%,respectively.Univariate analysis showed that tumor site,tumor size,positive margin,and cervical lymph node metastasis were significant prognostic factors for overall survival;facial numbness,positive margin were significant prognostic factors for local recurrences;and tumor site,cervical lymph node metastasis were significant prognostic factors for distant metastasis.Multivariate analysis showed that only positive margin and cervical lymph node metastasis remained as significant prognostic factors for overall survival.CONCLUSIONS:Recurrence,metastasis,and death occurred most frequently within 2 years after operation of PIOSCC.Positive margin and cervical lymph node metastasis were negative prognostic factors for PIOSCC.

关 键 词：原发性颌骨内鳞状细胞癌 预后因素 临床病理描述 

分 类 号：R739.8[医药卫生—肿瘤]