124例舌根鳞状细胞癌临床总结及预后分析

发布时间：2018-05-18 18:57

本文选题：舌根 + 癌　；参考：《临床耳鼻咽喉头颈外科杂志》2017年24期

【摘要】：目的:总结舌根鳞状细胞癌临床病理特征并分析其预后风险因素。方法:回顾性分析124例舌根鳞状细胞癌患者的临床资料。HPV-DNA检测采用HPV SPF10PCR/DEIA检测和LiPA分型法。生存率及单因素生存分析采用Kaplan-Meier法和Log-rank检验,多因素生存分析采用Cox回归模型。结果:124例舌根鳞状细胞癌患者5年疾病特异生存率为54.5%,总生存率为48.5%,中位总生存时间45.2个月。舌根鳞状细胞癌HPV感染率为18.3%(11/60),其中HPV-16亚型10例,占90.9%(10/11)。单因素分析结果显示长期吸烟史(P=0.028)、酗酒史(P=0.001)、肿瘤分期(P=0.009)及p16(P=0.015)蛋白表达情况均显著影响患者预后;HPV阳性舌根癌预后虽好于HPV阴性患者(5年生存率分别为80.8%和54.5%),但差异无统计学意义(P=0.138)。多因素生存分析显示影响舌根癌的独立预后因素为酗酒史(P=0.006)和肿瘤分期(P=0.035)。结论:舌根鳞状细胞癌预后相对较差,吸烟史、酗酒史、肿瘤分期及p16蛋白表达情况均显著影响患者预后,其中酗酒史和肿瘤分期为舌根癌的独立预后因素。
[Abstract]:Objective: to summarize the clinicopathological features and prognostic risk factors of tongue root squamous cell carcinoma. Methods: the clinical data of 124 patients with tongue root squamous cell carcinoma were analyzed retrospectively. HPV-DNA was detected by HPV SPF10PCR/DEIA and LiPA typing. Survival rate and univariate survival were analyzed by Kaplan-Meier method and Log-rank test, and multivariate survival analysis by Cox regression model. Results the 5-year disease-specific survival rate was 54.5 in 124 patients with squamous cell carcinoma of tongue root, the overall survival rate was 48.5 and the median survival time was 45.2 months. The infection rate of HPV in squamous cell carcinoma of tongue root was 18.3 / 60%, including 10 cases of HPV-16 subtype, accounting for 90.9% / 11%. The results of univariate analysis showed that the expression of P0. 028, P0. 001, P0. 009 and p16 + P0. 015) protein in chronic smoking history and alcoholic history significantly affected the prognosis of patients with HPV-positive tongue root carcinoma (80.8% vs 54.5%, respectively), but the 5-year survival rate was lower than that of HPV negative patients (80.8% and 54.5%, respectively). There was no statistical significance in the difference between the two groups (P < 0. 138). Multivariate survival analysis showed that the independent prognostic factors of tongue root carcinoma were alcoholism history (P0. 006) and tumor staging (P0. 035). Conclusion: the prognosis of squamous cell carcinoma of tongue root is relatively poor. Smoking history, history of alcoholism, tumor stage and p16 protein expression all significantly affect the prognosis of patients. The history of alcoholism and tumor stage are independent prognostic factors of tongue root carcinoma.
【作者单位】：中国人民解放军总医院耳鼻咽喉头颈外科;北京协和医学院中国医学科学院肿瘤医院头颈外科;北京协和医学院中国医学科学院肿瘤医院流行病学教研室;北京大学肿瘤医院头颈外科;
【基金】：解放军总医院科技创新苗圃基金(No:16KMM23)
【分类号】：R739.86

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