淋巴管浸润状态对阴茎鳞状细胞癌患者生存预后的影响  

Effects of status of lymph vascular invasion on the survival of patients with squamous cell carcinoma of the penis

作　　者：李明林[1] 任中海[2] 马慧利[2] 梅馨月 胡跃世[1] 杨立新[1] LI Minglin;REN Zhonghai;MA Huili;MEI Xinyue;HU Yueshi;YANG Lixin(Department of Urology,Nanyang Central Hospital,Nanyang 473000,China;Department of Oncology,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院泌尿外科,河南南阳473000 [2]南阳市中心医院肿瘤内科,河南南阳473000

出　　处：《现代泌尿外科杂志》2023年第7期597-602,共6页Journal of Modern Urology

基　　金：河南省医学科技攻关计划项目(No.LHGJ20191450)。

摘　　要：目的探讨淋巴管浸润(LVI)状态对阴茎鳞状细胞癌(SCCP)患者生存预后的影响。方法提取2010年1月1日-2019年12月31日美国国立癌症研究所的监测、流行病学和最终结果(SEER)数据库中诊断为SCCP患者的临床资料。使用Kaplan-Meier法绘制不同LVI状态SCCP患者的生存曲线并使用log-rank检验比较组间差异。使用Cox比例风险模型进行单因素和多因素分析LVI状态对SCCP患者总生存率的影响。按肿瘤分期(局限性、区域性、远处转移)、分化程度(高分化、中分化、低分化)分为不同的亚组,分析不同亚组中LVI状态对SCCP患者生存预后的影响。结果共计1435例患者被纳入研究,其中LVI阴性1102(76.8%)例,LVI阳性333(23.2%)例。中位生存时间LVI阴性患者为27.5个月,LVI阳性患者为17.0个月,两者间比较差异有统计学意义(0x0E䥺SymbolcA@0x0F 2=55.028,P<0.001)。Cox回归分析显示,LVI阳性是降低SCCP患者总生存率的独立危险因素(HR=1.280,95%CI为1.044~1.569,P=0.018)。亚组分析中,在局限性肿瘤(HR=1.446,95%CI为1.009~2.110,P=0.046)和区域性肿瘤(HR=1.323,95%CI为1.018~1.720,P=0.036)中,LVI阳性是降低SCCP患者总生存率的独立危险因素;在高分化肿瘤(HR=2.797,95%CI为1.573~4.971,P=0.046)和中分化肿瘤(HR=1.431,95%CI为1.071~1.914,P=0.015)中,LVI阳性也是降低SCCP患者总生存率的独立危险因素。结论LVI状态是影响SCCP患者总生存率的重要因素。在局限性、区域性肿瘤以及中分化、高分化肿瘤中,LVI阳性是影响SCCP患者总生存率的独立危险因素。Objective To explore the effects of status of lymph vascular invasion(LVI)on the survival of patients with squamous cell carcinoma of the penis(SCCP).Methods Data of patients diagnosed as SCCP during Jan.1,2010 and Dec.31,2019 were extracted from the Surveillance,Epidemiology,and End Results(SEER)database.Kaplan-Meier method was used to draw the survival curve of patients with different LVI statuses,and log-rank test was conducted in parallel.Univariate and multivariate Cox regression analyses were used to assess the effects of LVI status on the overall survival.Patients were divided into different subgroups based on stage(localized,regional,and distant metastasis)and grade(well,moderately and poorly differentiated)of tumor,and the effects of LVI status on the overall survival of patients in different subgroups were assessed.Results A total of 1435 patients were involved,including 1102(76.8%)without LVI and 333(23.2%)with LVI.Median survival time of patients without LVI and with LVI were 27.5 months and 17.0 months,respectively(χ2=55.028,P<0.001).Cox regression analyses showed LVI was a significant prognostic factor in SCCP patients(HR=1.280,95%CI:1.044-1.569,P=0.018).In the subgroup analysis,LVI was an independent risk factor affecting the overall survival of patients with localized tumor(HR=1.446,95%CI:1.009-2.110,P=0.046)and regional tumor(HR=1.323,95%CI:1.018-1.720,P=0.036);it was also an independent risk factor affecting the overall survival of SCCP patients with well differentiated tumor(HR=2.797,95%CI:1.573-4.971,P=0.046)and moderately differentiated tumor(HR=1.431,95%CI:1.071-1.914,P=0.015).Conclusion LVI status is a significant factor affecting the prognosis of SCCP patients.LVI is an independent risk factor for the overall survival of SCCP patients with localized and regional tumor,moderately differentiated and well differentiated tumor.

关 键 词：阴茎肿瘤 预后 生存分析 危险因素 淋巴管浸润 

分 类 号：R737.27[医药卫生—肿瘤]