喉癌预后相关因素的分析

发布时间：2018-05-25 04:36

  本文选题：喉鳞状细胞癌 + NLR　； 参考：《郑州大学》2016年硕士论文

【摘要】：目的喉癌是头颈部常见的恶性肿瘤。目前,由于环境污染的日益加重及吸烟饮酒人数的不断增多,其发病率也在随之升高。尽管医疗条件及医学技术较前大幅提高,但喉癌患者的生存率及生存质量较前却无明显改善。本文旨在分析影响喉癌患者预后的相关因素,为提高喉癌患者的生存率及生存质量提供依据。方法应用回顾性队列研究的方法分析了于2010年1月至2012年12月期间在郑州大学人民医院(河南省人民医院)收治的117例喉癌患者完整的临床资料,对可能影响喉癌患者预后的多项临床指标,如患者的性别、年龄、吸烟量、饮酒量、合并症情况、术前中性粒细胞与淋巴细胞的比值(NLR)、临床分型、喉癌分型、T分期、N分期、肿瘤的分化程度、手术方式、颈部淋巴结清扫情况、切缘情况、治疗方案等因素进行了严密的检测及记录。使用SPSS 17.0软件进行统计学分析,运用Kaplan-Meier法进行单因素生存分析,Log-rank进行检验,并建立Cox比例风险回归模型对患者预后进行多因素分析。均以P0.05具有统计学意义。结果本组喉癌患者共计117例,截止至随访结束日期,92例存活,25例死亡。随访时间均超过36个月。本组喉癌患者1年总生存率(OS)为84%,3年总生存率(OS)为81%,5年总生存率(OS)为70%。其中Ⅰ期、Ⅱ期、Ⅲ期和Ⅳ期喉癌患者的3年总生存率(OS)分别为87%、82%、70%和62%,5年总生存率(OS)分别为75%、77%、70%和62%。运用Kaplan-Meier法对可能影响喉癌患者预后的诸多因素进行单因素生存分析,结果提示患者因素中的年龄、吸烟包年量、NLR和肿瘤因素中的病理分化程度、喉癌分型、TN分期、临床分型均是影响喉癌预后的相关因素;建立Cox比例风险回归模型对相关指标进行多因素分析,结果显示肿瘤的病理分化程度及N分期是影响喉癌患者预后的独立危险因素。结论倡导健康的生活习惯,根据喉癌患者的自身情况及肿瘤的TNM分期给予及时、正确的诊治,选择恰当的治疗方案彻底去除肿瘤,正确处理颈部淋巴结,从而为患者预后提供保障。
[Abstract]:Objective laryngeal carcinoma is a common malignant tumor in head and neck. At present, due to the increasing environmental pollution and the increasing number of smoking and drinking, the incidence of the disease is also increasing. The survival rate and quality of life of laryngeal cancer patients were not significantly improved, although the medical conditions and medical techniques were significantly improved. The purpose of this paper is to analyze the factors influencing the prognosis of patients with laryngeal carcinoma, and to provide evidence for improving the survival rate and quality of life of patients with laryngeal carcinoma. Methods A retrospective cohort study was used to analyze the complete clinical data of 117 patients with laryngeal cancer admitted to the people's Hospital of Zhengzhou University (Henan people's Hospital) from January 2010 to December 2012. The clinical parameters that may affect the prognosis of laryngeal cancer patients, such as sex, age, smoking, alcohol consumption, complications, the ratio of neutrophils to lymphocytes before operation, clinical classification, T stage and N stage of laryngeal carcinoma, were analyzed. The degree of differentiation, operation, neck lymph node dissection, incisal margin, treatment plan and other factors were closely examined and recorded. SPSS 17.0 software was used for statistical analysis, Kaplan-Meier method was used for univariate survival analysis and Log-rank test, and Cox proportional risk regression model was established for multivariate analysis of prognosis. All had statistical significance with P0.05. Results there were 117 patients with laryngeal carcinoma and 25 patients died by the end of follow-up. All patients were followed up for more than 36 months. The 1-year overall survival rate was 84%, the 3-year overall survival rate was 81%, and the 5-year overall survival rate was 70%. The 3-year overall survival rate of patients with stage 鈪，

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