口腔癌颈部淋巴结清扫术中病理评估与预后的相关性  

Correlation Between Intraoperative Pathologic Assessment and Prognosis of Cervical Lymph Node Dissection for Oral Cancer

作　　者：郑雪莉 张建丽[1] 谷峰[1] ZHENG Xueli;ZHANG Jianli;GU Feng(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,471000)

机构地区：[1]河南科技大学第一附属医院,471000

出　　处：《实用癌症杂志》2025年第4期598-602,共5页The Practical Journal of Cancer

摘　　要：目的探讨口腔癌颈部淋巴结清扫术中病理评估与患者预后的相关性。方法纳入了96例接受原发病灶扩大切除术和颈部淋巴结清扫术的口腔癌患者,根据预后情况分为存活组(n=68)和死亡组(n=28),收集2组患者的基本信息和淋巴结病理特征。采用单变量和多变量Cox回归分析来确定影响预后的风险因素。采用华盛顿大学生活质量问卷评估患者生活质量,并分析其与淋巴结病理特征的关系。结果与存活组相比,死亡组中TNM分期晚期(Ⅲ~Ⅳ期)、淋巴结转移、短长径比(≥0.5)较高、窦组织细胞增生和生发中心增生的患者比例明显较高(P<0.05)。多因素Cox回归分析显示TNM分期晚期、淋巴结转移、生发中心增生和窦组织细胞增生是预后不良的独立危险因素(P<0.05)。受试者操作工作特征曲线分析发现回归模型具有较高的准确性(AUC=0.911)、灵敏度(91.52%)和特异性(86.25%),拟合度良好(χ^(2)=4.124,P=0.776)。生活质量评分结果显示,淋巴结转移和生发中心增生患者的UW-QoL评分明显较低(P<0.05)。结论TNM分期晚期、淋巴结转移、生发中心增生和窦组织细胞增生是口腔癌患者预后不良的重要独立风险因素。Objective Correlation between intraoperative pathological evaluation and prognosis of neck lymph node dissection in oral cancer.Methods Ninety-eight patients with oral cancer who underwent extended resection of the primary lesion and cervical lymph node dissection were enrolled.They were divided into the survival group(n=68)and death group(n=28)according to prognosis.Basic information and lymph node pathologic characteristics of patients in each group were collected.Univariate and multivariate Cox regression analyses were used to determine prognostic risk factors.The University of Washington Quality of Life Questionnaire(UW-QoL)scores were used to analyse the relationship between lymph node pathologic characteristics and patients'quality of survival.Results Compared with the survival group,the proportion of patients with advanced TNM stage(Ⅲ~Ⅳ),lymph node metastasis,short length diameter ratio(≥0.5),sinus histiocytosis and germinal center hyperplasia in the death group was significantly higher(P<0.05).Multivariate Cox regression analysis showed that late TNM stage,lymph node metastasis,germinal center hyperplasia and sinus histiocytosis were independent risk factors for poor prognosis(P<0.05).The receiver operating characteristic curve analysis showed that the regression model had high accuracy(AUC=0.911),sensitivity(91.52%)and specificity(86.25%),and good fitting(χ^(2)=4.124,P=0.776).The UW QOL score of patients with lymph node metastasis and germinal center hyperplasia was significantly lower(P<0.05).Conclusion Advanced TNM stage,lymph node metastasis,germinal center hyperplasia and sinus histiocytosis are important independent risk factors for poor prognosis in patients with oral cancer.

关 键 词：口腔癌 颈部淋巴结清扫术 窦组织细胞增生 生发中心增生 预后模型 

分 类 号：R739.8[医药卫生—肿瘤]