中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2021, Vol. 19 ›› Issue (5): 449-455.doi: 10.19438/j.cjoms.2021.05.012

• 论著 • 上一篇    下一篇

638例舌鳞癌预后及影响因素分析

叶晨1, 蔡云1, 赵小妹1, 张陈平1, 赵耐青2   

  1. 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.复旦大学公共卫生学院 生物统计学教研室,上海 200032
  • 收稿日期:2021-05-24 修回日期:2021-07-12 出版日期:2021-09-20 发布日期:2021-10-20
  • 通讯作者: 赵耐青,E-mail：nqzhao@126.com
  • 作者简介:叶晨（1975-）,女,硕士,副编审,E-mail：belindayeyyy@hotmail.com

Prognostic factors of oral tongue squamous cell carcinoma: a retrospective study of 638 cases

YE Chen1, CAI Yun1, ZHAO Xiao-mei1, ZHANG Chen-ping1, ZHAO Nai-qing2   

  1. 1. 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;
    2. Department of Biostatistics, School of Public Health, Shanghai Medical College, Fudan University. Shanghai 200032, China
  • Received:2021-05-24 Revised:2021-07-12 Online:2021-09-20 Published:2021-10-20

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摘要： 目的 研究舌鳞癌患者人口学及临床病理特征对总生存率的影响,筛选可能的预后影响因素。方法 选择2003—2013年间在上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科经病理确诊为舌鳞癌、户籍所在地为上海的住院患者。从住院病史中提取年龄、性别等人口学特征,病变部位、TNM分期、临床分期、组织学分级等临床病理特征数据。采用Stata/SE 10.0统计软件,Kaplan-Meier生存分析计算1、3、5年总生存率,Log-rank检验比较各因素不同水平生存分布的差异,Cox 比例风险模型筛选预后影响因素。结果 638例舌鳞癌患者纳入研究,1、3、5年生存率分别为83.52%、68.98%、63.33%。年龄>60岁与≤60岁生存率有统计学差异,>60岁者死亡风险增高（P<0.05）;性别经年龄分层后,≤60岁舌鳞癌患者生存率有性别差异,女性预后较好（P<0.05）;舌体鳞癌患者总生存率比舌根鳞癌患者高（P<0.05）。多因素回归分析显示,与舌鳞癌预后有关的因素有T分期、N分期,分期越高,预后越差（P<0.05）;组织学分级则仅有高分化与低分化对预后影响差异显著,低分化者预后极差（P<0.05）。结论 年龄、性别、肿瘤部位、TNM分期和组织学分级等均是舌鳞癌的预后影响因素。

关键词: 舌鳞癌, 生存分析, 预后因素, Cox回归模型

Abstract: PURPOSE: To investigate the impact of clinical and pathological characteristics on survival of patients with oral tongue squamous cell carcinoma （OTSCC）, and to analyze the factors predicting survival outcome. METHODS: A retrospective analysis of 638 patients diagnosed with OTSCC at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2003 to December 2013 was performed. Details on patient characteristics and tumor characteristics were recorded by retrospective review of patients' charts. Survival data acquisition was retrieved from Shanghai registry database of resident cancer by Shanghai Center for Disease Control and Prevention. Standard descriptive statistics were used to summarize patient demographic and disease-related data. Pearson Chi-square, Kaplan-Meier, Log-rank test, and Cox proportional hazards regression analysis were performed with Stata/SE 10.0 software package, and only variables with P<0.05 in univariate analysis were included in multivariable regression models. RESULTS: The 1-year, 3-year, and 5-year overall survival of 638 patients were 83.52%, 68.98% and 63.33%, respectively. Univariate analysis indicated that age> 60 years, males below 60 years, base of tongue, higher T stage, N stage were predictors of poor outcome. In multivariate analysis, several predictors of compromised overall survival were T stage, N stage and histopathological grade. T stage and N stage were strong independent predictors of poorer overall survival. CONCLUSIONS: Age, sex, lesion, T stage, N stage and histopathologic grading are prognostic factors for OTSCC patients.

Key words: Oral tongue squamous cell carcinoma, Overall survival, Prognostic factor, Cox proportional hazards model

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